| 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 | 2034174472 |
| 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 | 11/19/2015 |
| 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 |
| Provider Name | Dianne S Hammersley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942358452 PECOS PAC ID: 3375646961 Enrollment ID: I20070320000538 |
| Provider Name | Dorica D Nevin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063781672 PECOS PAC ID: 0749447001 Enrollment ID: I20120130000433 |
| Provider Name | Heather A Mahoney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225463987 PECOS PAC ID: 4981909397 Enrollment ID: I20160223002014 |
| Provider Name | Debbie Cardona |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114150042 PECOS PAC ID: 9436440484 Enrollment ID: I20160622000190 |
| Provider Name | Theresa Wiblishauser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275916389 PECOS PAC ID: 4082908017 Enrollment ID: I20160812001886 |
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