Healthcare Provider Details

I. General information

NPI: 1124174024
Provider Name (Legal Business Name): JULIE JEANNINE KLECKER LCMHC, LPC, PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/30/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 BALLS MILL RD
NORTH WILKESBORO NC
28659-9533
US

IV. Provider business mailing address

755 BALLS MILL RD
NORTH WILKESBORO NC
28659-9533
US

V. Phone/Fax

Practice location:
  • Phone: 336-298-2944
  • Fax: 336-818-5444
Mailing address:
  • Phone: 336-298-2944
  • Fax: 336-818-5444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401009820
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPC016231
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10138
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401009820
License Number StateMI
# 5
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC016231
License Number StatePA
# 6
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10138
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: