Dynamic Engagement Institute, L3C

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

0470084103 Issued in VT

Legal business name

DYNAMIC ENGAGEMENT INSTITUTE, L3C

Doing business as

Sapphire Center

Practice address

87 Rivers Bend Rd
New Haven, VT 05472-1101

Phone

(802) 388-3887

NPI assigned

Jul 12, 2012

Last updated

Jul 12, 2012By 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

Michele Aaron Fouts, MANPI 1164780946

Title

Owner/Director

Phone

(802) 388-3887

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Sapphire Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michele Aaron Fouts, MA

  • Clinical Psychologist
  • New Haven, VT
  • NPI 1164780946
  NPD (past) Authorized official

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

{
    "created_epoch": "1342051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342051200000",
    "number": "1174888408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 RIVERS BEND RD",
            "city": "NEW HAVEN",
            "state": "VT",
            "postal_code": "054721101",
            "telephone_number": "802-388-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 RIVERS BEND RD",
            "city": "NEW HAVEN",
            "state": "VT",
            "postal_code": "054721101",
            "telephone_number": "802-388-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC ENGAGEMENT INSTITUTE, L3C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-12",
        "last_updated": "2012-07-12",
        "status": "A",
        "authorized_official_last_name": "FOUTS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "802-388-3887",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "VT",
            "license": "0470084103",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "VT",
            "license": "0470084103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1020502",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sapphire Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Addison County Home Health& Hospice, Inc.
• Wanda Hier Bouvier
• Hilary Frost Boyle, MS CCC-SLP
• Mary-Katherine Clark
• Sara Daly, PT
• Michele Aaron Fouts, MA
• Joan Sharon Johnson
• Rebecca Kennedy, PH.D.
• Amanda Locker, RRT
• Stuart Moore Maccrellish, MSW

• Adolescent and Children Mental Health Clinic/Center in New Haven, VT
• Providers in New Haven, VT by specialty
• Adolescent and Children Mental Health Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2012; 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.