Healthcare Provider Details

I. General information

NPI: 1205103280
Provider Name (Legal Business Name): JULIA REILLY LCMHC, MLADC, C.F.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2011
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 COUNTY FARM RD
DOVER NH
03820-6003
US

IV. Provider business mailing address

272 COUNTY FARM RD
DOVER NH
03820-6003
US

V. Phone/Fax

Practice location:
  • Phone: 603-516-9737
  • Fax:
Mailing address:
  • Phone: 603-516-9737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0676
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1030
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: