Provider Demographics
NPI:1427280999
Name:DIMIZIO, JUDY KAY (LPCC)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:KAY
Last Name:DIMIZIO
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 VILLAGE WAY
Mailing Address - Street 2:SUITE 1/A
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-5109
Mailing Address - Country:US
Mailing Address - Phone:330-655-2674
Mailing Address - Fax:330-650-2609
Practice Address - Street 1:72 VILLAGE WAY
Practice Address - Street 2:SUITE 1/A
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-5109
Practice Address - Country:US
Practice Address - Phone:330-655-2674
Practice Address - Fax:330-650-2609
Is Sole Proprietor?:No
Enumeration Date:2009-08-18
Last Update Date:2009-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0004352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional