| Jd Psychological Services, Pc | |
|
10 Lower Cmns Woodbury CT 06798-3219 | |
| (203) 417-4472 | |
| Not Available |
| Full Name | Jd Psychological Services, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 10 Lower Cmns, Woodbury, Connecticut |
| Authorized Official Name and Position | Judith Davidson (OWNER) |
| Authorized Official Contact | 2038008614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jd Psychological Services, Pc 10 Lower Cmns Woodbury CT 06798-3219 Ph: (203) 417-4472 | Jd Psychological Services, Pc 10 Lower Cmns Woodbury CT 06798-3219 Ph: (203) 417-4472 |
| NPI Number | 1932573599 |
|---|---|
| Provider Enumeration Date | 11/19/2015 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Medicare PECOS PAC ID | 0648576553 |
|---|---|
| Medicare Enrollment ID | O20160302001487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932573599 | NPI | - | NPPES |
| 1649 | Other | CT | PROFESSIONAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1649 (Connecticut) | Primary |
| Provider Name | Judith K Davidson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154377984 PECOS PAC ID: 0244239622 Enrollment ID: I20061212000647 |
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