NPIMap

Organization Active NPI

Neuropsychological and Psychoeducational Services

  • Clinical Psychologist
  • Bellingham, WA
National Provider Identifier
1205146123
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00000736 Issued in WA
Legal business name
NEUROPSYCHOLOGICAL AND PSYCHOEDUCATIONAL SERVICES
Practice address
12 Bellwether Way
Suite 223
Bellingham, WA 98225-2959
Phone
(360) 255-2505
Fax
(360) 255-2504
NPI assigned
Oct 13, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Theodore Lewis Judd, PH.D.NPI 1255368833
Title
Owner
Phone
(360) 255-2505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X PY00000736 WA Primary

Addresses

Primary practice location

12 Bellwether Way
Suite 223
Bellingham, WA 98225-2959

Mailing address

12 Bellwether Way
Suite 223
Bellingham, WA 98225-2959
Phone (360) 255-2505

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1205146123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY",
            "address_2": "SUITE 223",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252959",
            "telephone_number": "360-255-2505",
            "fax_number": "360-255-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY",
            "address_2": "SUITE 223",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252959",
            "telephone_number": "360-255-2505",
            "fax_number": "360-255-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROPSYCHOLOGICAL AND PSYCHOEDUCATIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "LEWIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-255-2505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00000736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.