Provider Demographics
NPI:1306860168
Name:HOLDER, JUDITH BERNADATTE (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JUDITH
Middle Name:BERNADATTE
Last Name:HOLDER
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 1:385 TREMONT AVE
Mailing Address - Street 2:VA NJ HEALTH CARE SYSTEM
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017
Mailing Address - Country:US
Mailing Address - Phone:973-676-1000
Mailing Address - Fax:973-395-7995
Practice Address - Street 1:385 TREMONT AVE
Practice Address - Street 2:VA NJ HEALTH CARE SYSTEM
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1023
Practice Address - Country:US
Practice Address - Phone:973-676-1000
Practice Address - Fax:973-395-7995
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007520001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical