Provider Demographics
NPI:1740561406
Name:LABERT, JUDITH C (LPC)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:C
Last Name:LABERT
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 1:815 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6713
Mailing Address - Country:US
Mailing Address - Phone:541-245-2787
Mailing Address - Fax:541-201-8103
Practice Address - Street 1:815 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6713
Practice Address - Country:US
Practice Address - Phone:541-245-2787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1585101YP2500X
ORC5794101YP2500X
ORC4104101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional