Active NPI
Philip Foldeak
- Mental Health Counselor
- Brattleboro, VT
National Provider Identifier
1073710885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068-0000304
- Practice address
- 229 Western Ave
Brattleboro, VT 05301-6589 - Phone
- (802) 257-9444
- NPI assigned
- Jun 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068-0000304 | VT | Primary |
Addresses
Primary practice location
229 Western Ave
Brattleboro, VT 05301-6589
Mailing address
PO Box 60
West Chesterfield, NH 03466-0060
Phone (603) 256-6122
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010310 | Medicaid | VT | |
| 59682 | Other | VT | BLUE CROSS |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068-0000304 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1553644800000",
"number": "1073710885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60",
"city": "WEST CHESTERFIELD",
"state": "NH",
"postal_code": "034660060",
"telephone_number": "603-256-6122"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 WESTERN AVE",
"city": "BRATTLEBORO",
"state": "VT",
"postal_code": "053016589",
"telephone_number": "802-257-9444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLDEAK",
"first_name": "PHILIP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-27",
"last_updated": "2019-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068-0000304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1010310",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "59682",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brattleboro, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.