Provider Demographics
NPI:1508988510
Name:O'CALLAGHAN, JUDITH L (LMFT, LADC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:L
Last Name:O'CALLAGHAN
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 PLUMTREES RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1645
Mailing Address - Country:US
Mailing Address - Phone:203-743-1633
Mailing Address - Fax:203-791-8300
Practice Address - Street 1:246 FEDERAL RD STE 24
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-740-2595
Practice Address - Fax:203-740-2287
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000749101YA0400X
CT000999106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)