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General NPI Number Information
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NPI Number | 1760207237
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Entity Type | Individual
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Provider Name | JULIA MAE JOHNSON LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 12/03/2024
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Provider Practice Location Address
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Address Line | 83 ANDREWS RD
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City | VESTAL
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State | NY
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Zip | 13850-5323
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Country | US
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Telephone | 607-235-1439
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 68
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City | VESTAL
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State | NY
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Zip | 13851-0068
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Country | US
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Telephone |
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Fax |
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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 | 012721
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License Number State | NY
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