Individual
BETHANY JUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4009 N BROADWAY ST, CHICAGO, IL 60613-2110
(773) 275-2586
Mailing address
4009 N BROADWAY ST, CHICAGO, IL 60613-2110
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
150.108996
IL
1041C0700X
Clinical Social Worker
Primary
149.028744
IL
Other
Enumeration date
02/21/2024
Last updated
01/29/2025
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