Provider Demographics
NPI:1366800229
Name:CARBAJAL, JULIE (MA, LLP, LLPC, CAADC)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CARBAJAL
Suffix:
Gender:F
Credentials:MA, LLP, LLPC, CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 N ROSE ST STE 200
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-3874
Mailing Address - Country:US
Mailing Address - Phone:269-888-2418
Mailing Address - Fax:
Practice Address - Street 1:251 N ROSE ST STE 200
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-3874
Practice Address - Country:US
Practice Address - Phone:269-888-2418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401018787101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health