Provider Demographics
NPI:1396813812
Name:JUDD, ROBIN RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:RENEE
Last Name:JUDD
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 1:20 SQUADRON BLVD
Mailing Address - Street 2:SUITE 680
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5200
Mailing Address - Country:US
Mailing Address - Phone:845-270-8849
Mailing Address - Fax:845-357-4231
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:SUITE 680
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5200
Practice Address - Country:US
Practice Address - Phone:845-270-8849
Practice Address - Fax:845-357-4231
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0690241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical