Provider Demographics
NPI:1598079501
Name:RICHARDSON, JUDITH LEE (LMHC, CAP, SAP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LEE
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:LMHC, CAP, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 VINE TREE TRL APT B
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8535
Mailing Address - Country:US
Mailing Address - Phone:561-602-0006
Mailing Address - Fax:561-429-4010
Practice Address - Street 1:537 US HIGHWAY 1 STE 2
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4903
Practice Address - Country:US
Practice Address - Phone:561-602-0006
Practice Address - Fax:561-429-4010
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2015-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3341101YA0400X
FL9834101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)