Provider Demographics
NPI:1841608254
Name:TROTTER, JUDITH LEIGH (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LEIGH
Last Name:TROTTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 W CHURCH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-4333
Mailing Address - Country:US
Mailing Address - Phone:970-214-0317
Mailing Address - Fax:
Practice Address - Street 1:131 W CHURCH ST STE 200
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-4333
Practice Address - Country:US
Practice Address - Phone:970-214-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCSW 40085101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health