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Julie Ann Moylan

Counselor

Behavioral Health & Social Service Providers

116 Chestnut St E # 150, Stillwater, MN 55082-5116

PECOS Enrollment

This provider is enrolled in PECOS as JULIE MOYLAN.

Based on the most recent information from CMS, provider Julie Ann Moylan is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1255856928
Provider Type
Individual
Full Name
Moylan, Julie Ann
Credential
MA, LADC, LPCC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
8/3/2017
Last Updated
9/13/2018

Contact Information

Practice Location

116 Chestnut St E # 150, Stillwater, MN 55082-5116

(651) 494-4583

Unlisted Fax

Mailing Location

204 Cherry St W Apt 3, Stillwater, MN 55082-6771

(651) 494-4583

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License 1896 Minnesota
Code 101YA0400X	Description Counselor Behavioral Health & Social Service Providers	License 304182 Minnesota
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 01861 Minnesota

Julie Ann Moylan

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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