Provider Demographics
NPI:1578640199
Name:ANDREWS, JUDITH M (LCPC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:M
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 MIDDLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:ARUNDEL
Mailing Address - State:ME
Mailing Address - Zip Code:04046-7501
Mailing Address - Country:US
Mailing Address - Phone:207-774-7002
Mailing Address - Fax:207-967-3888
Practice Address - Street 1:650 MAIN ST
Practice Address - Street 2:#203
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-5448
Practice Address - Country:US
Practice Address - Phone:207-774-2007
Practice Address - Fax:207-967-3888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC 91101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health