Active NPI
Maryann L Neuzil, MA, LADC
- Clinical Psychologist
- Burlington, VT
National Provider Identifier
1295865434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 047-0000677
- Practice address
- 3 Main St
Suite 107
Burlington, VT 05401-5216 - Phone
- (802) 651-7528
- NPI assigned
- Mar 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047-0000677 | VT | Primary |
Addresses
Primary practice location
3 Main St
Suite 107
Burlington, VT 05401-5216
Mailing address
53 Machia Hill Rd
Westford, VT 05494-9742
Phone (802) 879-6220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1006514 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240531002542 | VT | Practitioner - Psychologist Billing Independently | 4486096757 | Practice locations: Burlington, VT |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047-0000677 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295865434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 MACHIA HILL RD",
"city": "WESTFORD",
"state": "VT",
"postal_code": "054949742",
"telephone_number": "802-879-6220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 MAIN ST",
"address_2": "SUITE 107",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015216",
"telephone_number": "802-651-7528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUZIL",
"first_name": "MARYANN",
"middle_name": "L",
"credential": "MA, LADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "047-0000677",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1006514",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.