Provider Demographics
NPI:1285726406
Name:TEILL, JUDY F (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:F
Last Name:TEILL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3587 DUTCHMANS LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3213
Mailing Address - Country:US
Mailing Address - Phone:502-452-6341
Mailing Address - Fax:502-452-6718
Practice Address - Street 1:3587 DUTCHMANS LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3213
Practice Address - Country:US
Practice Address - Phone:502-452-6341
Practice Address - Fax:502-452-6718
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0420101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health