Julian David Affrime, MA, LPC
Individual provider Active NPI Professional Counselor · Fredericktown, MO
NPI 1568809804 · NPPES record last updated Sep 16, 2024
Key facts
- NPI
- 1568809804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2019034783 (MO)
- Practice address
- 309 Garrett St
Fredericktown, MO 63645-1084 - Phone
- (573) 783-4104
- Fax
- (573) 783-4572
- NPI assigned
- May 28, 2013
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2019034783 | MO | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2019034783 | MO | Yes |
Addresses
Primary practice location
309 Garrett St
Fredericktown, MO 63645-1084
Mailing address
309 Garrett St
Fredericktown, MO 63645-1084
Phone (573) 783-4104
Other providers in Fredericktown, MO
- John S. Adams
- Cheryl Akers
- Michelle Leigh Austin
- Kyle Lee Bastie
- Jennifer Berkbigler
- Phillip Marion Beyer
All providers in Fredericktown, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.