Provider Demographics
NPI:1053880526
Name:YALE, JULIE ALYCE (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ALYCE
Last Name:YALE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ALYCE
Other - Last Name:POTVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-0433
Mailing Address - Country:US
Mailing Address - Phone:860-304-6073
Mailing Address - Fax:860-850-1036
Practice Address - Street 1:8 W MAIN ST STE 2-9
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-2331
Practice Address - Country:US
Practice Address - Phone:860-304-6073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002490101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional