Active NPI
Kimberly Corley, MA
- Clinical Psychologist
- Winooski, VT
National Provider Identifier
1023048642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 047-0000706
- Practice address
- 20 W Canal St
Suite C-11
Winooski, VT 05404-2131 - Phone
- (802) 651-7520
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047-0000706 | VT | Primary |
Addresses
Primary practice location
20 W Canal St
Suite C-11
Winooski, VT 05404-2131
Mailing address
20 W Canal St
Suite C-11
Winooski, VT 05404-2131
Phone (802) 651-7520
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047-0000706 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1023048642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 W CANAL ST",
"address_2": "SUITE C-11",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054042131",
"telephone_number": "802-651-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 W CANAL ST",
"address_2": "SUITE C-11",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "054042131",
"telephone_number": "802-651-7520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORLEY",
"first_name": "KIMBERLY",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "047-0000706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winooski, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.