Green Mountain Psychological Associates, P.C.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0470111914 Issued in VT

Legal business name

GREEN MOUNTAIN PSYCHOLOGICAL ASSOCIATES, P.C.

Practice address

79 Court St
Middlebury, VT 05753-1406

Phone

(802) 353-6580

NPI assigned

Sep 8, 2016

Last updated

Sep 8, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Danielle Rae Bergeron Ingram, M.S.

Title

Ceo

Phone

(802) 353-6580

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1473292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473292800000",
    "number": "1053868976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 COURT ST # A",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057534423",
            "telephone_number": "802-353-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 COURT ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531406",
            "telephone_number": "802-353-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN MOUNTAIN PSYCHOLOGICAL ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-08",
        "last_updated": "2016-09-08",
        "status": "A",
        "authorized_official_last_name": "BERGERON INGRAM",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-353-6580",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "0470111914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen J Ginsburg, COUNSELOR
• Wendy Goodwin, L.AC.
• Daniel Robert Gosselin, PT
• Robert Rene Gosselin
• Green Mountain Primary Care PLC
• Marian S Greenberg, MSW
• Amy Andrews Gregory, M.D.
• Kyleigh Grennon, APRN, PMHNP
• Curtis A Gross, DC
• Bernadette Guidry, M.S.

• Psychologist in Middlebury, VT
• Providers in Middlebury, VT by specialty
• Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2016; 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.