Healthcare Provider Details

I. General information

NPI: 1841117561
Provider Name (Legal Business Name): JULIE PIERRE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2011 S 25TH ST STE 108
FORT PIERCE FL
34947-4795
US

IV. Provider business mailing address

19001 NE 14TH AVE APT 245
NORTH MIAMI BEACH FL
33179-4051
US

V. Phone/Fax

Practice location:
  • Phone: 772-242-1079
  • Fax: 772-242-1296
Mailing address:
  • Phone: 772-242-1079
  • Fax: 772-242-1296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberIMH21788
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: