Provider Demographics
NPI:1801918727
Name:BOSWORTH, JUDITH HELENE (LMHC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:HELENE
Last Name:BOSWORTH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 9TH ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-4122
Mailing Address - Country:US
Mailing Address - Phone:360-293-0446
Mailing Address - Fax:360-293-9231
Practice Address - Street 1:1020 9TH ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-4122
Practice Address - Country:US
Practice Address - Phone:360-293-0446
Practice Address - Fax:360-293-9231
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005250101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health