Provider Demographics
NPI:1053751339
Name:STIGGER, JUDITH A (LCSW)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:STIGGER
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 1:329 N SCOVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2262
Mailing Address - Country:US
Mailing Address - Phone:847-293-3956
Mailing Address - Fax:
Practice Address - Street 1:2049 RIDGE AVE
Practice Address - Street 2:THE CRADLE
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2713
Practice Address - Country:US
Practice Address - Phone:847-475-5800
Practice Address - Fax:847-475-5871
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0023691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical