Provider Demographics
NPI:1235569013
Name:JUDSON CENTER, INC.
Entity Type:Organization
Organization Name:JUDSON CENTER, INC.
Other - Org Name:AUTISM CONNECTION
Other - Org Type:Other Name
Authorized Official - Title/Position:CERTIFIED MEDICAL BILLER AND CODER
Authorized Official - Prefix:
Authorized Official - First Name:CHONDELLA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:LINDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-554-6362
Mailing Address - Street 1:4410 W 13 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-6515
Mailing Address - Country:US
Mailing Address - Phone:248-549-4339
Mailing Address - Fax:248-549-8955
Practice Address - Street 1:4410 W 13 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-6515
Practice Address - Country:US
Practice Address - Phone:248-549-4339
Practice Address - Fax:248-549-8955
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JUDSON CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-15
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty