Individual
MR. DAVID JUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
504 MICAH DRIVE, DRAWER M, OLNEY, IL 62450-0913
(618) 395-4306
(618) 395-4507
Mailing address
504 MICAH DRIVE, PO DRAWER M, OLNEY, IL 62450-0913
(618) 395-4306
(618) 395-4507
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
180004995
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180004995
LCPC
IL
Enumeration date
10/09/2007
Last updated
11/15/2012
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