Provider Demographics
NPI:1679236079
Name:LANDSAW, JULIE DAVIS (LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:DAVIS
Last Name:LANDSAW
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 1:16901 DALLAS PARKWAY,ADDISON, TX
Mailing Address - Street 2:STE. 107
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001
Mailing Address - Country:US
Mailing Address - Phone:214-448-7767
Mailing Address - Fax:
Practice Address - Street 1:16901 DALLAS PARKWAY,ADDISON, TX
Practice Address - Street 2:STE. 107
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001
Practice Address - Country:US
Practice Address - Phone:214-448-7767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77067101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health