Individual
DR. TIMOTHY DAVID LE JACQ-SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
501 ANGELL ST, PROVIDENCE, RI 02906-4467
(401) 243-4199
Mailing address
8 AIMES WAY, WESTPORT, MA 02790-1260
(401) 243-4199
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS00764
RI
103TC0700X
Clinical Psychologist
8125
MA
103TC0700X
Clinical Psychologist
Primary
PS00764
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034540
BEACON HEALTH ID NUMBER
RI
01
—
26545-2
BCBSRPROVIDER NUMBERI
RI
01
—
410489
BLUE CHIP RI PROVIDER ID
RI
Enumeration date
08/16/2006
Last updated
02/05/2026
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