Jodie Lyn Bisson, M.A.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

047-0000632 Issued in VT

Practice address

15 Pinecrest Dr
Essex Junction, VT 05452-2912

Phone

(802) 288-1087

Fax

(802) 878-4404

NPI assigned

Feb 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1073587960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015297",
            "telephone_number": "802-865-3450",
            "fax_number": "802-860-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PINECREST DR",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054522912",
            "telephone_number": "802-288-1087",
            "fax_number": "802-878-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISSON",
        "first_name": "JODIE",
        "middle_name": "LYN",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "047-0000632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005484",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Basa, DPT
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• Sheren Boca, PHARMD / RPH
• Mary Carter Bradshaw, MSW
• Nicole Lafko Breslend, PH.D.
• Shane Isaac Brichacek, PHARMD

• Psychologist in Essex Junction, VT
• Providers in Essex Junction, VT by specialty
• Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.