Jonathan Adam Dudek, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS1103 Issued in ME

Practice address

136 Mill St
Princeton, ME 04668-3344

Phone

(207) 796-5503

Fax

(207) 796-5528

NPI assigned

Dec 27, 2012

Last updated

Jun 8, 2015By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1356687040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 MILL ST",
            "city": "PRINCETON",
            "state": "ME",
            "postal_code": "046683344",
            "telephone_number": "207-796-5503",
            "fax_number": "207-796-5528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 MILL ST",
            "city": "PRINCETON",
            "state": "ME",
            "postal_code": "046683344",
            "telephone_number": "207-796-5503",
            "fax_number": "207-796-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDEK",
        "first_name": "JONATHAN",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-27",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1103",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "1052",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Cassidy, LPN
• Beth Ann Chabre, NP
• Lawrence Crystal, DPM
• Deborah Lynn Daggett, L.A.D.C
• Michael J Driscoll, LCPC, LADC, CCS
• Tara CL Dwelley, CNP
• Gregory Michael Farrell, O.D.
• Michael Farrell, D.C.
• Carol Francis, RN
• Merlin J Francis, NP

• Clinical Psychologist in Princeton, ME
• Providers in Princeton, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.