Provider Demographics
NPI:1619153699
Name:MITZEL, JULIE M (LPC)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:M
Last Name:MITZEL
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 1:1501 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-2713
Mailing Address - Country:US
Mailing Address - Phone:701-255-3325
Mailing Address - Fax:701-250-6469
Practice Address - Street 1:1501 N 12TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-2713
Practice Address - Country:US
Practice Address - Phone:701-255-3325
Practice Address - Fax:701-250-6469
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND437-12-1-99101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health