Provider Demographics
NPI:1043448947
Name:ALLEN, JULINE (MS, LMHC)
Entity type:Individual
Prefix:
First Name:JULINE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 N HARBOR CITY BLVD #100
Mailing Address - Street 2:
Mailing Address - City:WEST MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3661
Mailing Address - Country:US
Mailing Address - Phone:321-209-1299
Mailing Address - Fax:321-517-2900
Practice Address - Street 1:152 N HARBOR CITY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-6794
Practice Address - Country:US
Practice Address - Phone:321-209-1299
Practice Address - Fax:321-517-2900
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2024-12-31
Deactivation Date:2024-04-12
Deactivation Code:
Reactivation Date:2024-05-23
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FLMH23827101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator