Healthcare Provider Details

I. General information

NPI: 1669519815
Provider Name (Legal Business Name): JULIE JULIE CLEMENTS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 03/07/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 EIGHTH ST., STE 4
MORGAN CITY LA
70380
US

IV. Provider business mailing address

1109 EIGHTH ST., STE 4
MORGAN CITY LA
70380
US

V. Phone/Fax

Practice location:
  • Phone: 985-519-7057
  • Fax: 985-313-1012
Mailing address:
  • Phone: 985-519-7057
  • Fax: 985-313-1012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2276
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2276
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: