Sutherland, Judith Denise
Sutherland, Judith Denise is an individual health care provider with primary practice located at 2990 N Broadway Ave , Tyler TX 75702-2149. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Sutherland, Judith Denise can be contacted via phone (903) 535-9041.Contact Information
Primary practice address
2990 N Broadway Ave
Tyler TX 75702-2149
Phone: (903) 535-9041
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 53473 | Texas |
Profile Details
| NPI number | 1851611503 |
|---|---|
| LBN Legal business name | Sutherland, Judith Denise |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2010 |
| Last updated | Jan 24th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1851611503 | NPPES |
| Texas | MEDICAID | 203375501 |
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