Healthcare Provider Details

I. General information

NPI: 1205124096
Provider Name (Legal Business Name): JULIANNA NEMITZ QUICK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 08/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 FRONT ROYAL PIKE SUITE 200
WINCHESTER VA
22602-4346
US

IV. Provider business mailing address

3091 PATRIOT CT
BROADWAY VA
22815-3337
US

V. Phone/Fax

Practice location:
  • Phone: 540-667-8888
  • Fax: 540-667-5663
Mailing address:
  • Phone: 540-746-8206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701005066
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: