Provider Demographics
NPI:1609000298
Name:CREECY, JUDITH M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:M
Last Name:CREECY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:M
Other - Last Name:GUIDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:500 WESTOVER DR # 13619
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-8941
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1218 WOODS RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:NY
Practice Address - Zip Code:12526-5626
Practice Address - Country:US
Practice Address - Phone:480-235-7934
Practice Address - Fax:602-685-6001
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-09851041C0700X
NY0821701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical