Smith, Judson D.

Smith, Judson D. is an individual health care provider with primary practice located at 62 Elm St , Portland ME 04101-3091. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Smith, Judson D. can be contacted via phone (207) 553-7056.

Contact Information

Primary practice address
62 Elm St Portland ME 04101-3091
Phone: (207) 553-7056
Fax: (207) 773-2082
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS352 Maine
Behavioral Health & Social Service Providers / Psychologist 103T00000X PS352 Maine

Profile Details

NPI number 1518937242
LBN Legal business name Smith, Judson D.
Credentials ED.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 25th, 2006
Last updated Oct 3rd, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518937242 NPPES
Maine Other 098303 ANTHEM LEGACY NUMBER

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