MEDICARE: JULIE HUSSEY LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH11461	FL

General Provider Information

NPI Number	:	1093120404
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE HUSSEY LMHC

Provider Business Mailing Address
First Line	:	125 S STATE ROAD 7 STE 104-178
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4385
Country	:	US
Telephone Number	:	954-328-8664
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 S STATE ROAD 7 STE 104-178
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-4385
Country	:	US
Telephone Number	:	954-328-8664
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2014
Last Update Date	:	04/25/2022

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