Provider Demographics
NPI:1740425370
Name:FAINTICH, JUDY COHEN (LPC)
Entity Type:Individual
Prefix:MS
First Name:JUDY
Middle Name:COHEN
Last Name:FAINTICH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 LANDMARK PARKWAY
Mailing Address - Street 2:SUITE 17
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-842-6223
Mailing Address - Fax:314-842-6124
Practice Address - Street 1:9735 LANDMARK PARKWAY DR
Practice Address - Street 2:SUITE 17
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63127-1646
Practice Address - Country:US
Practice Address - Phone:314-842-6223
Practice Address - Fax:314-842-6124
Is Sole Proprietor?:No
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001029959101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional