Provider Demographics
NPI:1235363466
Name:MCCARTY, JUDITH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:A
Last Name:MCCARTY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:A
Other - Last Name:URLAUB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:135 FAR HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-1908
Mailing Address - Country:US
Mailing Address - Phone:203-372-0887
Mailing Address - Fax:203-374-3907
Practice Address - Street 1:135 FAR HORIZON DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-1908
Practice Address - Country:US
Practice Address - Phone:203-374-6215
Practice Address - Fax:203-374-3907
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-01
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001089101Y00000X
FL1-02-0817103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101Y00000XBehavioral Health & Social Service ProvidersCounselor