Provider Demographics
NPI:1831141357
Name:WILLIAMSON, JUDITH M (LCMHC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:M
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 THE GREEN
Mailing Address - Street 2:SUITE # 5
Mailing Address - City:WOODSTOCK
Mailing Address - State:VT
Mailing Address - Zip Code:05091
Mailing Address - Country:US
Mailing Address - Phone:802-457-3302
Mailing Address - Fax:802-457-2433
Practice Address - Street 1:218 HARTLAND HILL RD.
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VT
Practice Address - Zip Code:05091
Practice Address - Country:US
Practice Address - Phone:802-457-3620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT49356OtherVT BCBS
VT1007387Medicaid