Provider Demographics
NPI:1679010300
Name:LARKIN, JULIE (MA, NCC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LARKIN
Suffix:
Gender:F
Credentials:MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 E MAIN ST STE 214
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4066
Mailing Address - Country:US
Mailing Address - Phone:503-648-6827
Mailing Address - Fax:
Practice Address - Street 1:233 E MAIN ST STE 214
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4066
Practice Address - Country:US
Practice Address - Phone:503-648-6827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR4541101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional