Provider Demographics
NPI:1083902803
Name:CULVER, JUDI M (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JUDI
Middle Name:M
Last Name:CULVER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4397 SEQUOIA DR
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:WI
Mailing Address - Zip Code:53598-9613
Mailing Address - Country:US
Mailing Address - Phone:608-846-5327
Mailing Address - Fax:
Practice Address - Street 1:8025 EXCELSIOR DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53717-1900
Practice Address - Country:US
Practice Address - Phone:608-663-4367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4793-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional