Healthcare Provider Details

I. General information

NPI: 1922682996
Provider Name (Legal Business Name): JUDITH F. KURTIS LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921B N BETHLEHEM PIKE FL 3
AMBLER PA
19002-1319
US

IV. Provider business mailing address

341 CASALS PL
AMBLER PA
19002-2735
US

V. Phone/Fax

Practice location:
  • Phone: 215-292-8437
  • Fax:
Mailing address:
  • Phone: 215-292-8437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JUDITH F. KURTIS
Title or Position: OWNER
Credential: LCSW
Phone: 215-292-8437