Basic Information
Provider Information
NPI: 1811318058
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JULY
FirstName: ERIKA
MiddleName: MARIE
NamePrefix: MS.
NameSuffix: X
Credential: MS, LLPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber: 3134504500
FaxNumber: 3134504512
Practice Location
Address1: 9315 TELEGRAPH RD
Address2:  
City: REDFORD
State: MI
PostalCode: 482391260
CountryCode: US
TelephoneNumber: 3134504500
FaxNumber: 3134504512
Other Information
ProviderEnumerationDate: 12/13/2013
LastUpdateDate: 03/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X6401013176MIN Behavioral Health & Social Service ProvidersCounselorProfessional
101YM0800X6401013176MIY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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