Provider Demographics
NPI:1477760288
Name:HOLMAN, JUDY (CDP, LMHC, LSW)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:CDP, LMHC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 132
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WA
Mailing Address - Zip Code:98592-0132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7440 W MARGINAL WAY S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-4141
Practice Address - Country:US
Practice Address - Phone:206-768-1990
Practice Address - Fax:206-768-8910
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003111101YA0400X
WALH00006808101YM0800X
WALW00006768104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker