Provider Demographics
NPI:1083624498
Name:MCINERNEY, JUDITH A (PSY D)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:A
Last Name:MCINERNEY
Suffix:
Gender:
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 DEBORAH DR
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33950-8179
Mailing Address - Country:US
Mailing Address - Phone:312-510-7509
Mailing Address - Fax:
Practice Address - Street 1:1090 S TAMIAMI TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-9116
Practice Address - Country:US
Practice Address - Phone:941-363-0878
Practice Address - Fax:833-449-5224
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY9294103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical