Provider Demographics
NPI:1376552455
Name:GOBLIRSCH, JUDY E (LPC)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:E
Last Name:GOBLIRSCH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 39151
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-1151
Mailing Address - Country:US
Mailing Address - Phone:210-872-1068
Mailing Address - Fax:
Practice Address - Street 1:6007 WILDWIND DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-2128
Practice Address - Country:US
Practice Address - Phone:210-872-1068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19420101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX19147OtherPROVIDER NUMBER COMMFIRST
TX7055LCOtherPROVIDER NUMBER BLUECROSS