Provider Demographics
NPI:1013098847
Name:O'LEARY-SARGEANT, JUDY L (PHD)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:L
Last Name:O'LEARY-SARGEANT
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 1:4716 SWORDFISH DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603
Mailing Address - Country:US
Mailing Address - Phone:585-303-8903
Mailing Address - Fax:585-586-8603
Practice Address - Street 1:1135 KILDARE FARM RD
Practice Address - Street 2:SUITE 200-7
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-415-4716
Practice Address - Fax:585-586-8603
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5870103TC0700X
NY014378103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP010014373OtherBCBS