Provider Demographics
NPI:1477627099
Name:ROBISON, JUDY RED (LCSW, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:RED
Last Name:ROBISON
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-7240
Mailing Address - Country:US
Mailing Address - Phone:985-624-3978
Mailing Address - Fax:
Practice Address - Street 1:1800 W CAUSEWAY APPROACH
Practice Address - Street 2:SUITE 106
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-2971
Practice Address - Country:US
Practice Address - Phone:985-807-3128
Practice Address - Fax:985-626-0042
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical