Provider Demographics
NPI:1205936390
Name:FARRINGTON, JUDITH L (LMFT)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:L
Last Name:FARRINGTON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:F
Other - Last Name:WAGMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:616 GOLDSTAR HWY
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:CT
Mailing Address - Zip Code:06340
Mailing Address - Country:US
Mailing Address - Phone:860-449-0200
Mailing Address - Fax:860-449-1954
Practice Address - Street 1:616 GOLDSTAR HWY
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340
Practice Address - Country:US
Practice Address - Phone:860-449-0200
Practice Address - Fax:860-449-1954
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000972106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist