Provider Demographics
NPI:1679656128
Name:ADELSON, JUDITH D (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:D
Last Name:ADELSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:JUDITH
Other - Middle Name:D
Other - Last Name:ADELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:425 RIVERSIDE DR
Mailing Address - Street 2:#8C
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10025-7728
Mailing Address - Country:US
Mailing Address - Phone:212-222-4486
Mailing Address - Fax:212-663-6444
Practice Address - Street 1:425 RIVERSIDE DR
Practice Address - Street 2:#8C
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10025-7728
Practice Address - Country:US
Practice Address - Phone:212-222-4486
Practice Address - Fax:212-663-6444
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0189101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N06931Medicare ID - Type Unspecified