Theodore Lewis Judd, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00000736 Issued in WA

Practice address

12 Bellwether Way
Suite 223
Bellingham, WA 98225-2959

Phone

(360) 255-2505

Fax

(360) 255-2504

NPI assigned

Jun 27, 2006

Last updated

Apr 3, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neuropsychological and Psychoeducational Services

  • Clinical Psychologist
  • Bellingham, WA
  • NPI 1205146123
  NPD Authorized official
• Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Seatac, WA
  • NPI 1962628297
  NPD (past)

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1255368833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BELLWETHER WAY",
            "address_2": "STE 223",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982252914",
            "telephone_number": "360-543-8333",
            "fax_number": "360-543-8332"
        },
        {
            "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": {
        "last_name": "JUDD",
        "first_name": "THEODORE",
        "middle_name": "LEWIS",
        "name_prefix": "Mr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00000736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7115900",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyful Rain Therapy, PLLC
• Hannah Margaret Joyner, OD
• JSN Inc
• Jonah Judd
• Kendra Lin Judd, PA-C
• Pollyann Brooke Judkins, SUDPT
• Skye M June
• James Juneau, RPH
• Janice Marie Jung, M.ED.
• Lisa A. Jungclas, PHD

• Clinical Psychologist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.