Provider Demographics
NPI:1831448844
Name:JAMES, JUDITH MARIE (EDD, LADC)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:MARIE
Last Name:JAMES
Suffix:
Gender:F
Credentials:EDD, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 UNIVERSITY AVE SE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3325
Mailing Address - Country:US
Mailing Address - Phone:612-454-2282
Mailing Address - Fax:612-454-2340
Practice Address - Street 1:3329 UNIVERSITY AVE SE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3325
Practice Address - Country:US
Practice Address - Phone:612-454-2282
Practice Address - Fax:612-454-2340
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN303270101YA0400X
101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral