Provider Demographics
NPI:1093283442
Name:PAZMINO, JUDITH (LPC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:PAZMINO
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 1:163 KNOX RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-1512
Mailing Address - Country:US
Mailing Address - Phone:203-921-7180
Mailing Address - Fax:
Practice Address - Street 1:1200 HIGH RIDGE RD STE 2
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1202
Practice Address - Country:US
Practice Address - Phone:475-419-5696
Practice Address - Fax:203-664-5021
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-04
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional