Provider Demographics
NPI:1255392783
Name:POWER, JUDITH ANN (PSYD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:POWER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 WINDING COVE RD
Mailing Address - Street 2:
Mailing Address - City:MARSTONS MILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02648-1823
Mailing Address - Country:US
Mailing Address - Phone:508-274-6465
Mailing Address - Fax:
Practice Address - Street 1:1170 ROUTE 6A
Practice Address - Street 2:POB 302
Practice Address - City:WEST BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02668-1142
Practice Address - Country:US
Practice Address - Phone:508-362-6227
Practice Address - Fax:508-362-6227
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-02
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4705103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0524476Medicaid
MA277709OtherPHCS
MA095892OtherMHN
MA222929OtherHARVARD-PILGRIM HEALTHCAR
MAWO4670OtherBLUE CROSS/BLUE SHIELD
MA081769OtherVALUE OPTIONS
MA162504000OtherMAGELLAN
MA692411026OtherFIRST HEALTH
MA61-21452OtherUNITED HEALTHCARE
MA87726OtherUNITED BEHAVIORAL HEALTH
MAS016602OtherCHAMPUS/TRICARE
MA0007329123OtherAETNA
MA1050340OtherCIGNA
MA222929OtherHARVARD-PILGRIM HEALTHCAR