Individual provider Active NPI

Tiffany Elizabeth Trombley, LCMHC, LMHC

  • Mental Health Counselor
  • Swanton, VT
National Provider Identifier
1205119682
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068-0074342 Issued in VT
Practice address
663 Monument Rd
Swanton, VT 05488-1134
Phone
(802) 309-3544
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12936 MA
Mental Health Counselor 101YM0800X 068-0074342 VT Primary

Addresses

Primary practice location

663 Monument Rd
Swanton, VT 05488-1134

Mailing address

PO Box 491
St Albans Bay, VT 05481-0491
Phone (802) 395-1317

Other names 1

  • Tiffany Elizabeth Turner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, VT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240208001287 MA Practitioner - Mental Health Counselor 0143663997 Reassigns benefits to 1 organization
I20240208001872 VT Practitioner - Mental Health Counselor 0143663997 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068-0074342VTMDMental Health Counselor
12936MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC CurrentSince Jan 26, 2024 Accepting new patients

Locations

90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889

145 Pine Haven Shores Rd
Shelburne, VT 05482
Phone (802) 316-4135

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1205119682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 491",
            "city": "ST ALBANS BAY",
            "state": "VT",
            "postal_code": "054810491",
            "telephone_number": "802-395-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 MONUMENT RD",
            "city": "SWANTON",
            "state": "VT",
            "postal_code": "054881134",
            "telephone_number": "802-309-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLEY",
        "first_name": "TIFFANY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LCMHC, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "12936",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068-0074342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "TURNER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Swanton, VT

Sources for this page

Verify at the official NPI Registry.