Provider Demographics
NPI:1700928587
Name:ASHWAY, JUDITH ANNE (MSW LICSW BCD)
Entity type:Individual
Prefix:MR
First Name:JUDITH
Middle Name:ANNE
Last Name:ASHWAY
Suffix:
Gender:F
Credentials:MSW LICSW BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68 LEONARD ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BELMONT
Mailing Address - State:MA
Mailing Address - Zip Code:02478
Mailing Address - Country:US
Mailing Address - Phone:617-489-0254
Mailing Address - Fax:617-484-9301
Practice Address - Street 1:68 LEONARD ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478
Practice Address - Country:US
Practice Address - Phone:617-489-0254
Practice Address - Fax:617-484-9301
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1039401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ASP20371Medicare ID - Type Unspecified