Provider Demographics
NPI:1679789598
Name:WEIGAND, JULIE R (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:R
Last Name:WEIGAND
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 EARNEST S BRAZILL ST
Mailing Address - Street 2:#A
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4620
Mailing Address - Country:US
Mailing Address - Phone:253-627-8053
Mailing Address - Fax:253-627-8203
Practice Address - Street 1:620 EARNEST S BRAZILL ST
Practice Address - Street 2:#A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4620
Practice Address - Country:US
Practice Address - Phone:253-627-8053
Practice Address - Fax:253-627-8203
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
WALH60085390101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist