Provider Demographics
NPI:1679133284
Name:WEST, JULIE (LPC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2030 PROSPECT RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:HADDON HGTS
Mailing Address - State:NJ
Mailing Address - Zip Code:08035-1027
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2030 PROSPECT RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:HADDON HGTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1027
Practice Address - Country:US
Practice Address - Phone:267-777-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-17
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 101YP2500X
PAPC011371101YP2500X
NJ37PC00774500101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional