Provider Demographics
NPI:1770698649
Name:JUDD, EMILY (LMSW, LLP, PSYD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:JUDD
Suffix:
Gender:F
Credentials:LMSW, LLP, PSYD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:JENSEN
Other - Last Name:JUDD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW, LLP, PSYD
Mailing Address - Street 1:28511 ORCHARD LAKE RD STE A
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2933
Mailing Address - Country:US
Mailing Address - Phone:586-489-1550
Mailing Address - Fax:
Practice Address - Street 1:28511 ORCHARD LAKE RD STE A
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2933
Practice Address - Country:US
Practice Address - Phone:586-489-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2023-05-31
Deactivation Date:2021-06-22
Deactivation Code:
Reactivation Date:2022-03-15
Provider Licenses
StateLicense IDTaxonomies
MI68010852591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical