Healthcare Provider Details

I. General information

NPI: 1598184897
Provider Name (Legal Business Name): JULIE CIPES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 WEST ST STE B
PLANTSVILLE CT
06479-1140
US

IV. Provider business mailing address

341 WEST ST STE B
PLANTSVILLE CT
06479-1140
US

V. Phone/Fax

Practice location:
  • Phone: 860-276-3000
  • Fax: 860-276-3002
Mailing address:
  • Phone: 860-276-3000
  • Fax: 860-276-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2517
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: