Provider Demographics
NPI:1568990422
Name:MOLINA, JUDITH A (LMHC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:A
Last Name:MOLINA
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 228202
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33222-8202
Mailing Address - Country:US
Mailing Address - Phone:786-863-3572
Mailing Address - Fax:
Practice Address - Street 1:11200 SW 8TH ST RM 140
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33199-5827
Practice Address - Country:US
Practice Address - Phone:786-348-0477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH15518101YM0800X
FL15518103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health