Provider Demographics
NPI:1811475676
Name:SERFATY, JUDITH MINNA (LCPC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:MINNA
Last Name:SERFATY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WOOD HILL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8724
Mailing Address - Country:US
Mailing Address - Phone:301-838-4200
Mailing Address - Fax:014-681-8623
Practice Address - Street 1:200 WOOD HILL RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8724
Practice Address - Country:US
Practice Address - Phone:301-838-4200
Practice Address - Fax:301-468-1862
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC8701101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health