Healthcare Provider Details

I. General information

NPI: 1023970126
Provider Name (Legal Business Name): JULIA RUDICK MA, LAPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 N STATE ST
CLARKS SUMMIT PA
18411-1062
US

IV. Provider business mailing address

1251 WYOMING AVE
EXETER PA
18643-1434
US

V. Phone/Fax

Practice location:
  • Phone: 570-324-8434
  • Fax: 570-299-2521
Mailing address:
  • Phone: 570-324-8434
  • Fax: 570-299-2521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPC001932
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: