Provider Demographics
NPI:1487284477
Name:LOPEZ, JULIE ANN (LMHC, MA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMHC, MA
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4805 S COYOTE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-2516
Mailing Address - Country:US
Mailing Address - Phone:509-728-1813
Mailing Address - Fax:
Practice Address - Street 1:9 S WASHINGTON ST STE 310
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-5117
Practice Address - Country:US
Practice Address - Phone:509-728-1813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-19
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WA60660665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health