Provider Demographics
NPI:1679848469
Name:MUELLER, JUDITH A (MSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:A
Last Name:MUELLER
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLD FOREST RD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:CT
Mailing Address - Zip Code:06784-2136
Mailing Address - Country:US
Mailing Address - Phone:203-240-1450
Mailing Address - Fax:
Practice Address - Street 1:246 FEDERAL RD.
Practice Address - Street 2:SUITE C23
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804
Practice Address - Country:US
Practice Address - Phone:203-240-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0075711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT549395OtherMHN MANAGED HEALTH NETWORK
CT008057243Medicaid
CT12349349OtherCAQH
CT060669107OtherUBH/CONNECTICARE WELLMORE GRP/FACILITY
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT008057243Medicaid
CT060669107OtherUBH/UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CTPENDINGOtherCAQH
CTPENDINGOtherCIGNA BEHAVIORAL HEALTH
CT060669107OtherOPTUM BEHAVIORAL HEALTH/UBH WELLMORE GRP/FACILITY
CT549395 PENDINGOtherMHN TRICARENORTH
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILITY
CTPENDINGMedicare PIN