Active NPI
Julianne Sample, LPC
- Mental Health Counselor
- Goodyear, AZ
National Provider Identifier
1104663442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-23159
- Practice address
- 2990 N Litchfield Rd Ste 7
Goodyear, AZ 85395-7800 - Phone
- (602) 842-2754
- NPI assigned
- Jul 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-23159 | AZ | Primary |
Addresses
Primary practice location
2990 N Litchfield Rd Ste 7
Goodyear, AZ 85395-7800
Mailing address
5416 W Coles Rd
Laveen, AZ 85339-7143
Phone (303) 359-4539
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-23159 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721001600000",
"number": "1104663442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5416 W COLES RD",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "853397143",
"telephone_number": "303-359-4539"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2990 N LITCHFIELD RD STE 7",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853957800",
"telephone_number": "602-842-2754"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPLE",
"first_name": "JULIANNE",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-12",
"last_updated": "2024-07-15",
"certification_date": "2024-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC-23159",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Goodyear, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.