Provider Demographics
NPI:1821200924
Name:WILLIAMS, JUDITH G (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:G
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:EAST LYME
Mailing Address - State:CT
Mailing Address - Zip Code:06333-1526
Mailing Address - Country:US
Mailing Address - Phone:860-440-3008
Mailing Address - Fax:860-440-3021
Practice Address - Street 1:5 SHAWS CV
Practice Address - Street 2:SUITE 207
Practice Address - City:NEW LONDON
Practice Address - State:CT
Practice Address - Zip Code:06320-4974
Practice Address - Country:US
Practice Address - Phone:860-440-3008
Practice Address - Fax:860-440-3021
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000793106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist