Provider Demographics
NPI:1083654974
Name:MATHEA, JUDY PRICER (LPC)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:PRICER
Last Name:MATHEA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6616 ST. JOHNS DR.
Mailing Address - Street 2:APT. 1002
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-2716
Mailing Address - Country:US
Mailing Address - Phone:817-891-3268
Mailing Address - Fax:
Practice Address - Street 1:801 A KENNEDALE SUBLETT RD
Practice Address - Street 2:
Practice Address - City:KENNEDALE
Practice Address - State:TX
Practice Address - Zip Code:76060
Practice Address - Country:US
Practice Address - Phone:817-483-0020
Practice Address - Fax:817-572-6676
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13419101YP2500X
TXLPC13419101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10011545OtherAMERIGROUP
KY175463OtherMHN
UT21751114OtherUNITED HEALTHCARE
MO586314000OtherMAGELLAN
TX1586604Medicaid
IL234449OtherCOM PSYCH
CA550010006887OtherPACIFICARE
TX7228540OtherAETNA
SC76060A003OtherTRICARE
MN2200770OtherCIGNA
TX83738LOtherBLUE CROSS BLUE SHIELD