Provider Demographics
NPI:1356095855
Name:JAMEL, JUDY ANN MARIE (LCSWA)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN MARIE
Last Name:JAMEL
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANN MARIE
Other - Last Name:PANGBORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 LIVE OAK CT
Mailing Address - Street 2:
Mailing Address - City:MIDWAY PARK
Mailing Address - State:NC
Mailing Address - Zip Code:28544-1664
Mailing Address - Country:US
Mailing Address - Phone:252-503-0868
Mailing Address - Fax:
Practice Address - Street 1:2801 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2838
Practice Address - Country:US
Practice Address - Phone:252-636-6007
Practice Address - Fax:252-672-0009
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0172511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical