Individual provider Active NPI

Jon Judge, LCPC

  • Professional Counselor
  • Columbia, MD
National Provider Identifier
1871042283
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LC7285 Issued in MD
Practice address
6355 Woodside CT
Columbia, MD 21046-1071
Phone
(410) 381-7171
Fax
(410) 381-4480
NPI assigned
Sep 27, 2016
Last updated
Sep 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC7285 MD Primary

Addresses

Primary practice location

6355 Woodside CT
Columbia, MD 21046-1071

Mailing address

6355 Woodside CT
Columbia, MD 21046-1071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241009001749 MD Practitioner - Mental Health Counselor 0143751586 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1311 S Main St
Suite 202
Mount Airy, MD 21771-5457
Phone (877) 622-0013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC Current Accepting new patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince Sep 25, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince Sep 25, 2024 Accepting new patients

Locations

1311 S Main St
Ste 202
Mount Airy, MD 21771
Phone (301) 829-2242

650 Ritchie Hwy
Ste 207
Severna Park, MD 21146
Phone (410) 315-9350

1380 Progress Way
Ste 101
Sykesville, MD 21784
Phone (410) 549-5181

11000 Optum Cir
Eden Prairie, MN 55344

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1871042283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6355 WOODSIDE CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6355 WOODSIDE CT",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461071",
            "telephone_number": "410-381-7171",
            "fax_number": "410-381-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDGE",
        "first_name": "JON",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-27",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC7285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.