Provider Demographics
NPI:1619306321
Name:WEBB, JUDITH BRENT (LPCA)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:BRENT
Last Name:WEBB
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:MISS
Other - First Name:JUDITH
Other - Middle Name:ANN
Other - Last Name:BRENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCA
Mailing Address - Street 1:2434 PARKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1047
Mailing Address - Country:US
Mailing Address - Phone:502-451-9317
Mailing Address - Fax:502-451-9317
Practice Address - Street 1:2434 PARKDALE AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1047
Practice Address - Country:US
Practice Address - Phone:502-451-9317
Practice Address - Fax:502-451-9317
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1096101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health