Provider Demographics
NPI:1194898049
Name:CANTOR, JUDITH C (MSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:C
Last Name:CANTOR
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:C
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2012 NE 65TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6934
Mailing Address - Country:US
Mailing Address - Phone:206-526-8137
Mailing Address - Fax:206-367-0919
Practice Address - Street 1:2012 NE 65TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6934
Practice Address - Country:US
Practice Address - Phone:206-526-8137
Practice Address - Fax:206-367-0919
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000061441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical