Provider Demographics
NPI:1922165265
Name:PASKIEWICZ, JUDITH MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:MARIE
Last Name:PASKIEWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N OLD WOODWARD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009
Mailing Address - Country:US
Mailing Address - Phone:248-642-3337
Mailing Address - Fax:248-642-3224
Practice Address - Street 1:800 N OLD WOODWARD AVE STE 210
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-3802
Practice Address - Country:US
Practice Address - Phone:248-642-3337
Practice Address - Fax:248-642-3224
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801009862104100000X
MI6301008361103T00000X
MI4101005955106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F33001OtherBCBS
023727OtherVALUE OPTIONS
5047088OtherAETNA
MI0F33001OtherBCBS