Individual provider Active NPI

Lorraine K Clodfelter, M.S.

  • Clinical Psychologist
  • Montpelier, VT
National Provider Identifier
1255475554
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
258 Issued in VT
Practice address
18 Langdon St
Montpelier, VT 05602-3080
Phone
(802) 223-0850
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 258 VT Primary

Addresses

Primary practice location

18 Langdon St
Montpelier, VT 05602-3080

Mailing address

921 Old West Church Rd
Adamant, VT 05640-7017
Phone (802) 229-0967

Other identifiers 1

IdentifierTypeStateIssuer
1004331MedicaidVT

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
258VTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255475554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 OLD WEST CHURCH RD",
            "city": "ADAMANT",
            "state": "VT",
            "postal_code": "056407017",
            "telephone_number": "802-229-0967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 LANGDON ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056023080",
            "telephone_number": "802-223-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLODFELTER",
        "first_name": "LORRAINE",
        "middle_name": "K",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004331",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.