Provider Demographics
NPI:1144315748
Name:LAIR, JUDY A (LPCC)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:A
Last Name:LAIR
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6827 N HIGH ST
Mailing Address - Street 2:SUITE 232
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-2517
Mailing Address - Country:US
Mailing Address - Phone:614-893-5603
Mailing Address - Fax:614-436-3764
Practice Address - Street 1:6827 N HIGH ST
Practice Address - Street 2:SUITE 232
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-2517
Practice Address - Country:US
Practice Address - Phone:614-893-5603
Practice Address - Fax:614-436-3764
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0007720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH269402980005OtherMEDICAL MUTUAL INS. PIN
OH000000393694OtherANTHEM BLUE CROSS BLUE SHIELD