Provider Demographics
NPI:1407062086
Name:COUWELS, JUDY L (MA,, LMFT)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:L
Last Name:COUWELS
Suffix:
Gender:F
Credentials:MA,, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 SW 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-5449
Mailing Address - Country:US
Mailing Address - Phone:954-321-4180
Mailing Address - Fax:954-321-4597
Practice Address - Street 1:200 NW 27TH AVE
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-8648
Practice Address - Country:US
Practice Address - Phone:954-321-4180
Practice Address - Fax:954-321-4597
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1110106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist