Healthcare Provider Details

I. General information

NPI: 1881124576
Provider Name (Legal Business Name): JULIE JOHNSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2017
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 E RUSSELL AVE STE A4
WARRENSBURG MO
64093-1242
US

IV. Provider business mailing address

10 CEDAR RD
WELLSVILLE MO
63384-4502
US

V. Phone/Fax

Practice location:
  • Phone: 660-429-6678
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2017014818
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: