NPIMap

Organization Active NPI

Christianne Judy LCSW LLC

  • Mental Health Counselor
  • O Fallon, IL
National Provider Identifier
1922572148
Registry record updated Jun 5, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
CHRISTIANNE JUDY LCSW LLC
Practice address
635 S Lincoln Ave
O Fallon, IL 62269-2663
Phone
(314) 518-7897
NPI assigned
Jan 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Authorized official

Name
Mrs. Christianne M Judy, LCSW
Title
Psychotherapist
Phone
(314) 518-7897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

635 S Lincoln Ave
O Fallon, IL 62269-2663

Mailing address

635 S Lincoln Ave
O Fallon, IL 62269-2663
Phone (314) 518-7897

National Provider Directory

National Provider Directory

Locations

635 S Lincoln Ave
O Fallon, IL 62269
Phone (314) 518-7897

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591315200000",
    "number": "1922572148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 S LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692663",
            "telephone_number": "314-518-7897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 S LINCOLN AVE",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692663",
            "telephone_number": "314-518-7897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANNE JUDY LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A",
        "authorized_official_last_name": "JUDY",
        "authorized_official_first_name": "CHRISTIANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "314-518-7897",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.