Provider Demographics
NPI:1881607406
Name:VIEUX, JUDY ANN (LMSW-CLINICAL)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:VIEUX
Suffix:
Gender:F
Credentials:LMSW-CLINICAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3096 GLOUCHESTER DR APT 82A
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-2726
Mailing Address - Country:US
Mailing Address - Phone:607-729-6206
Mailing Address - Fax:
Practice Address - Street 1:3096 GLOUCHESTER DR APT 82A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-2726
Practice Address - Country:US
Practice Address - Phone:607-729-6206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011085801041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRU8583Medicare ID - Type Unspecified