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General NPI Number Information
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NPI Number | 1235160128
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Entity Type | Individual
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Provider Name | JULIE BERNE SPEASMAKER L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 505 FAULCONER DR SUITE 2D
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-4981
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Country | US
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Telephone | 434-295-2226
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Fax | 434-977-4952
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Provider Business Mailing Address
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Address Line | 355 BLOOMFIELD RD
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22903-7838
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Country | US
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Telephone | 434-295-2226
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Fax | 434-977-4952
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State | VA
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