Provider Demographics
NPI:1265646137
Name:MAUSNER, JUDITH SARA (LCSW MSW BCD)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:SARA
Last Name:MAUSNER
Suffix:
Gender:F
Credentials:LCSW MSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 HERITAGE LANE
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3018
Mailing Address - Country:US
Mailing Address - Phone:631-689-7358
Mailing Address - Fax:
Practice Address - Street 1:8 HERITAGE LANE
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3018
Practice Address - Country:US
Practice Address - Phone:631-689-7358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02859611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical