Individual
JULIE SHORTRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
5991 PARKWAY NORTH BLVD STE B4, CUMMING, GA 30040-1342
(404) 274-5209
(770) 818-5607
Mailing address
PO BOX 2927, CUMMING, GA 30028-6512
(404) 274-5209
(770) 818-5607
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC003547
GA
1041C0700X
Clinical Social Worker
S-0008535
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201559520
TID
GA
01
—
201559520
TID
—
Enumeration date
06/16/2005
Last updated
09/24/2018
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