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NPI Code Detail

MEDICARE: JUDITH A WINTERS LCSW INC

MEDICARE: JUDITH A WINTERS LCSW INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCS 20588CA

General Provider Information

NPI Number : 1477672434
Entity Type Code : Organization
Provider Name (Legal Business Name) : JUDITH A WINTERS LCSW INC
Provider Business Mailing Address
First Line : PO BOX 12271
Second Line :
City : LA CRESCENTA
State : CA
Zip : 91224-0971
Country : US
Telephone Number : 626-590-7912
Fax Number : 818-249-5036
Provider Business Practice Location Address
First Line : 175 S LAKE AVE UNIT 201
Second Line :
City : PASADENA
State : CA
Zip : 91101-2629
Country : US
Telephone Number : 626-590-7912
Fax Number : 818-249-5036
Authorized Official
Title or Position : CEO
Name : JUDITH A WINTERS
Credential : LCSW
Telephone Number : 626-590-7912
Provider Enumeration Date : 03/28/2007
Last Update Date : 08/22/2020

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