Provider Demographics
NPI:1962955799
Name:JUDD, TAMA (LMHC)
Entity type:Individual
Prefix:
First Name:TAMA
Middle Name:
Last Name:JUDD
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 1:16 YARDARM DR
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3658
Mailing Address - Country:US
Mailing Address - Phone:508-477-6654
Mailing Address - Fax:
Practice Address - Street 1:16 YARDARM DR
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3658
Practice Address - Country:US
Practice Address - Phone:508-477-6654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-28
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5925101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health