MEDICARE: JULIE LUNDY ED.S., NBCC, LPC

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	101Y00000X	Counselor	6093	SC

General Provider Information

NPI Number	:	1467994921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE LUNDY ED.S., NBCC, LPC

Provider Business Mailing Address
First Line	:	PO BOX 6442
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29260-6442
Country	:	US
Telephone Number	:	803-931-0878
Fax Number	:

Provider Business Practice Location Address
First Line	:	4500 FORT JACKSON BLVD STE 110
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29209-1134
Country	:	US
Telephone Number	:	803-931-4249
Fax Number	:

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

Provider Enumeration Date	:	11/14/2016
Last Update Date	:	04/11/2022

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