Provider Demographics
NPI:1740314301
Name:CLINGMAN, JUDITH CHARLOTTE (MA, LMFT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:CHARLOTTE
Last Name:CLINGMAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19677 AQUA VIEW LN
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-9664
Mailing Address - Country:US
Mailing Address - Phone:310-749-2508
Mailing Address - Fax:310-317-7878
Practice Address - Street 1:19677 AQUA VIEW LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33913-9664
Practice Address - Country:US
Practice Address - Phone:310-749-2508
Practice Address - Fax:310-317-7878
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT36923106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist