Provider Demographics
NPI:1780085621
Name:TORKILDSEN SALMONS, JUDITH ELLEN (LMSW-CC)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ELLEN
Last Name:TORKILDSEN SALMONS
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6816
Mailing Address - Country:US
Mailing Address - Phone:207-847-2273
Mailing Address - Fax:
Practice Address - Street 1:500 ROUTE 1
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6816
Practice Address - Country:US
Practice Address - Phone:207-847-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC14524101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMC14524OtherSTATE OF MAINE LICENSE BOARD