Provider Demographics
NPI:1619675824
Name:JUDY, REBECCA (LMHC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:JUDY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14110 118TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1430
Mailing Address - Country:US
Mailing Address - Phone:206-618-5638
Mailing Address - Fax:
Practice Address - Street 1:14110 118TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-1430
Practice Address - Country:US
Practice Address - Phone:206-618-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health