Julie Shortridge, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC003547 Issued in GA

Practice address

5991 Parkway North Blvd Ste B4
Cumming, GA 30040-1342

Phone

(404) 274-5209

Fax

(770) 818-5607

NPI assigned

Jun 16, 2005

Last updated

Sep 24, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Julie Boblenz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A Life's Journey, Inc.

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  Authorized official Same address or phone
• A Life's Journey, Inc.

  • Professional Counselor
  • Grayson, GA
  • NPI 1740476589
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1609871631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2927",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300286512",
            "telephone_number": "404-274-5209",
            "fax_number": "770-818-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5991 PARKWAY NORTH BLVD STE B4",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401342",
            "telephone_number": "404-274-5209",
            "fax_number": "770-818-5607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2047 Grayson Highway",
            "address_purpose": "LOCATION",
            "city": "Grayson",
            "state": "GA",
            "postal_code": "30017",
            "country_code": "US",
            "telephone_number": "770-438-4100",
            "fax_number": "770-818-5607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORTRIDGE",
        "first_name": "JULIE",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC003547",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "S-0008535",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "201559520",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "201559520",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "BOBLENZ",
            "credential": "MA, LPC, LSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Professional Counselor in Cumming, GA
• Providers in Cumming, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.