Provider Demographics
NPI:1801148390
Name:ABUNAW, JUDITH E (MSW, LCSW-C, LICSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:ABUNAW
Suffix:
Gender:F
Credentials:MSW, LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 SCOTCH PINE DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2789
Mailing Address - Country:US
Mailing Address - Phone:240-355-1753
Mailing Address - Fax:
Practice Address - Street 1:1603 SCOTCH PINE DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2789
Practice Address - Country:US
Practice Address - Phone:240-355-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500793201041C0700X
MD213121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical