Provider Demographics
NPI:1477672434
Name:JUDITH A WINTERS LCSW INC
Entity Type:Organization
Organization Name:JUDITH A WINTERS LCSW INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:WINTERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:626-590-7912
Mailing Address - Street 1:PO BOX 12271
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91224-0971
Mailing Address - Country:US
Mailing Address - Phone:626-590-7912
Mailing Address - Fax:818-249-5036
Practice Address - Street 1:175 S LAKE AVE UNIT 201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2629
Practice Address - Country:US
Practice Address - Phone:626-590-7912
Practice Address - Fax:818-249-5036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 205881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty