Provider Demographics
NPI:1437449956
Name:PADUA, JUDITH (LSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:PADUA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 MOHAWK DR
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44055-2651
Mailing Address - Country:US
Mailing Address - Phone:440-934-9930
Mailing Address - Fax:440-934-9645
Practice Address - Street 1:4108 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-2651
Practice Address - Country:US
Practice Address - Phone:440-934-9930
Practice Address - Fax:440-934-9645
Is Sole Proprietor?:No
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.00322111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical