Provider Demographics
NPI:1912090192
Name:JUDGE, BRIAN F (MSW)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:F
Last Name:JUDGE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CROSBY CIR
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4735
Mailing Address - Country:US
Mailing Address - Phone:508-875-1150
Mailing Address - Fax:857-364-4477
Practice Address - Street 1:150 S HUNTINGTON AVE
Practice Address - Street 2:SOCIAL WORK SERVICE (122)
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02130-4817
Practice Address - Country:US
Practice Address - Phone:857-364-2821
Practice Address - Fax:857-364-4477
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1051381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical