Provider Demographics
NPI:1740404599
Name:HANCOX, JUDITH A (MSW, LCSW, BCETS)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:HANCOX
Suffix:
Gender:F
Credentials:MSW, LCSW, BCETS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7959 VT ROUTE 125
Mailing Address - Street 2:
Mailing Address - City:BRIDPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05734-4401
Mailing Address - Country:US
Mailing Address - Phone:802-758-2222
Mailing Address - Fax:
Practice Address - Street 1:7959 VT ROUTE 125
Practice Address - Street 2:
Practice Address - City:BRIDPORT
Practice Address - State:VT
Practice Address - Zip Code:05734-4401
Practice Address - Country:US
Practice Address - Phone:802-758-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.0000933101YM0800X
NJ44SC00866200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1740404599OtherMEDICARE INDIVIDUAL NPI NUMBER
NJ116634OtherMEDICARE PTAN
NJ021735OtherMEDICARE PIN
NJ1942492905OtherMEDICARE GROUP/SUPPLIER GROUP NPI NUMBER
NJ021735Medicare PIN