Provider Demographics
NPI:1629188461
Name:MCDUFFY, JUDITH D (LMHC)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:D
Last Name:MCDUFFY
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 1:8150 SW BARNES RD
Mailing Address - Street 2:J105
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6372
Mailing Address - Country:US
Mailing Address - Phone:503-505-3220
Mailing Address - Fax:
Practice Address - Street 1:8150 SW BARNES RD
Practice Address - Street 2:J105
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6372
Practice Address - Country:US
Practice Address - Phone:503-505-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMHC-31101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI990298651-96706-C003OtherTRICARE