Provider Demographics
NPI:1487751830
Name:DEMOOY, JUDY ANN (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:ANN
Last Name:DEMOOY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 QUEEN ELIZABETH AVE
Mailing Address - Street 2:#28
Mailing Address - City:MANTEO
Mailing Address - State:NC
Mailing Address - Zip Code:27954-9282
Mailing Address - Country:US
Mailing Address - Phone:270-519-1806
Mailing Address - Fax:
Practice Address - Street 1:PMB 21 2224 S. CROATAN HWY.
Practice Address - Street 2:UNIT D#7
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9442
Practice Address - Country:US
Practice Address - Phone:252-305-9405
Practice Address - Fax:252-255-0787
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0054461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical