Provider Demographics
NPI:1457566697
Name:FIELDS, JUDITH E (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:FIELDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:315 EAST 68TH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065
Mailing Address - Country:US
Mailing Address - Phone:917-842-3025
Mailing Address - Fax:
Practice Address - Street 1:315 E 68TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065
Practice Address - Country:US
Practice Address - Phone:917-842-3025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0766761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical