Provider Demographics
NPI:1164990701
Name:KURTIS, JUDITH (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:KURTIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 CASALS PL
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-2735
Mailing Address - Country:US
Mailing Address - Phone:301-807-2577
Mailing Address - Fax:
Practice Address - Street 1:921B N BETHLEHEM PIKE
Practice Address - Street 2:FL 3
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-1319
Practice Address - Country:US
Practice Address - Phone:215-292-8437
Practice Address - Fax:973-669-2569
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-12
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0185431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty