Provider Demographics
NPI:1992846224
Name:MUSGRAVE, JUDITH C (LPC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:C
Last Name:MUSGRAVE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:COLLINS
Other - Last Name:MUSGRAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:4825 S LABURNUM AVE
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23231-2713
Mailing Address - Country:US
Mailing Address - Phone:804-222-2607
Mailing Address - Fax:804-236-9118
Practice Address - Street 1:4825 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23231-2713
Practice Address - Country:US
Practice Address - Phone:804-222-2607
Practice Address - Fax:804-236-9118
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003619101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional