Provider Demographics
NPI:1871961482
Name:HITCHMON, JUDINE TESSIER (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JUDINE
Middle Name:TESSIER
Last Name:HITCHMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SE 6TH ST
Mailing Address - Street 2:
Mailing Address - City:DANIA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33004-4723
Mailing Address - Country:US
Mailing Address - Phone:202-779-8655
Mailing Address - Fax:
Practice Address - Street 1:20701 NE 10TH PATH
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-1940
Practice Address - Country:US
Practice Address - Phone:202-779-8655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW123451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical