Provider Demographics
NPI:1932948049
Name:TERESA JUDY COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:TERESA JUDY COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:PHIFER
Authorized Official - Last Name:JUDY
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCA
Authorized Official - Phone:980-269-7822
Mailing Address - Street 1:802 GW BROOME RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28112-9611
Mailing Address - Country:US
Mailing Address - Phone:980-269-7822
Mailing Address - Fax:
Practice Address - Street 1:802 GW BROOME RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-9611
Practice Address - Country:US
Practice Address - Phone:980-269-7822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty