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General NPI Number Information
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NPI Number | 1073889572
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Entity Type | Organization
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Legal Business Name | JULIE J. MCKEAN, LMHC, NCC, LLC
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 4929 VAN DYKE ROAD
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City | LUTZ
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State | FL
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Zip | 33558
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Country | US
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Telephone | 813-453-1151
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Fax | 813-281-2474
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Provider Business Mailing Address
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Address Line | 4929 VAN DYKE ROAD
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City | LUTZ
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State | FL
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Zip | 33558
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Country | US
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Telephone | 813-453-1151
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Fax | 813-281-2474
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MRS. JULIE J. MCKEAN
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Credential | LMHC
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Telephone | 813-453-1151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH7053
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License Number State | FL
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