NPIMap

Organization Active NPI

Long Trail Psychiatry, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Middlebury, VT
National Provider Identifier
1043083652
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LONG TRAIL PSYCHIATRY, LLC
Practice address
88 Main St Ste 201
Middlebury, VT 05753-1425
Phone
(802) 349-7498
NPI assigned
Nov 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Authorized official

Name
Lauren Bierman, DNP, APRNNPI 1326580440
Title
Owner
Phone
(802) 349-7498

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

88 Main St Ste 201
Middlebury, VT 05753-1425

Mailing address

6 Forest Ridge Rd
Middlebury, VT 05753-8717
Phone (802) 349-7498

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240220000284 VT Part B Supplier - Clinic/Group Practice 8527402429 Receives reassigned benefits from 5 practitioners
Practice locations: Middlebury, VT

National Provider Directory

National Provider Directory

Locations

88 Main St
Ste 201
Middlebury, VT 05753
Phone (413) 687-5175

99 Maple St
Ste 14
Middlebury, VT 05753
Phone (802) 234-8645

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1043083652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 FOREST RIDGE RD",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057538717",
            "telephone_number": "802-349-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 MAIN ST STE 201",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531425",
            "telephone_number": "802-349-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG TRAIL PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-05",
        "status": "A",
        "authorized_official_last_name": "BIERMAN",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "802-349-7498",
        "authorized_official_credential": "DNP, APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.