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Provider Information for 1952903593


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CHELSEA JULIAN LPC-IT


Sex: Female

NPI: 1952903593
Last Updated: 2023-05-26
Certification Date: 2023-05-26

Details

NameValue
NPI1952903593
Enumeration Date2020-11-09
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 1710 LAWRENCE DRIVE
200
DE PERE, WI 54115-4710
United States

Phone: 920-245-3484 | Fax:
 
Primary Practice Address 1710 LAWRENCE DRIVE
200
DE PERE, WI 54115-4710
United States

Phone: 920-245-3484 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101YM0800X - Counselor - Mental HealthWI4264
No 101YP2500X - Counselor - Professional
Yes 101YP2500X - Counselor - ProfessionalWI8778-125