Provider Demographics
NPI:1184601502
Name:BUCHMAN, JUDITH SIMPSON (MA LPC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:SIMPSON
Last Name:BUCHMAN
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 OAKMONT AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3250
Mailing Address - Country:US
Mailing Address - Phone:814-838-6493
Mailing Address - Fax:
Practice Address - Street 1:4021 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3354
Practice Address - Country:US
Practice Address - Phone:814-392-1865
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000362101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
472489OtherVALUE OPTIONS
1448342OtherHIGHMARK