Provider Demographics
NPI:1760406870
Name:ESTES, JUDITH (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:ESTES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3190 HALLMARK CT
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2190
Mailing Address - Country:US
Mailing Address - Phone:989-790-3366
Mailing Address - Fax:989-790-5027
Practice Address - Street 1:3190 HALLMARK CT
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-2190
Practice Address - Country:US
Practice Address - Phone:989-790-3366
Practice Address - Fax:989-790-5027
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010799771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical