Provider Demographics
NPI:1407948789
Name:JUDITH A. FRISBIE, CSW
Entity Type:Organization
Organization Name:JUDITH A. FRISBIE, CSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRISBIE
Authorized Official - Suffix:
Authorized Official - Credentials:CSW
Authorized Official - Phone:570-654-7451
Mailing Address - Street 1:508 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:WEST PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18643-2143
Mailing Address - Country:US
Mailing Address - Phone:570-654-7451
Mailing Address - Fax:
Practice Address - Street 1:508 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:WEST PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18643-2143
Practice Address - Country:US
Practice Address - Phone:570-654-7451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW007525L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015114540004Medicaid
S32614Medicare UPIN
PA0015114540004Medicaid