Provider Demographics
NPI:1013742725
Name:BARAJAS, JUDITH (LSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:BARAJAS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:BARAJAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LSW
Mailing Address - Street 1:25 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8696
Mailing Address - Country:US
Mailing Address - Phone:630-465-0211
Mailing Address - Fax:
Practice Address - Street 1:25 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8696
Practice Address - Country:US
Practice Address - Phone:630-465-0211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.112511104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker