Healthcare Provider Details

I. General information

NPI: 1306776463
Provider Name (Legal Business Name): JULIANNE TANYEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIANNE URBAN

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 DOUBLE CHURCHES RD
COLUMBUS GA
31909-2983
US

IV. Provider business mailing address

2302 ROCKY BROOK RD APT B
OPELIKA AL
36801-2457
US

V. Phone/Fax

Practice location:
  • Phone: 706-507-3694
  • Fax:
Mailing address:
  • Phone: 724-714-8622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC016734
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: