Provider Demographics
NPI:1134336746
Name:CLAIR, JUDITH EVANS (LPC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:EVANS
Last Name:CLAIR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9024 FLETCHERS MILL RD
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:VA
Mailing Address - Zip Code:20115-2035
Mailing Address - Country:US
Mailing Address - Phone:540-341-7397
Mailing Address - Fax:
Practice Address - Street 1:9024 FLETCHERS MILL RD
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:VA
Practice Address - Zip Code:20115-2035
Practice Address - Country:US
Practice Address - Phone:540-341-7397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001273101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0701001273OtherLICENSED PROFESSIONAL COU