Provider Demographics
NPI:1700688876
Name:ROSENDAHL, JULIAYN (MA, LPC)
Entity type:Individual
Prefix:
First Name:JULIAYN
Middle Name:
Last Name:ROSENDAHL
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35276 N EDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:INGLESIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60041-8708
Mailing Address - Country:US
Mailing Address - Phone:817-808-9723
Mailing Address - Fax:
Practice Address - Street 1:5400 W ELM ST STE 120
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-4035
Practice Address - Country:US
Practice Address - Phone:815-271-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.020962101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty