Healthcare Provider Details

I. General information

NPI: 1477760288
Provider Name (Legal Business Name): JUDY HOLMAN CDP, LMHC, LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7440 W MARGINAL WAY S
SEATTLE WA
98108-4141
US

IV. Provider business mailing address

PO BOX 132
UNION WA
98592-0132
US

V. Phone/Fax

Practice location:
  • Phone: 206-768-1990
  • Fax: 206-768-8910
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP00003111
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00006808
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW00006768
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: