Active NPI
Laurance Thompson, M.S.
- Clinical Psychologist
- Berlin, VT
National Provider Identifier
1336259365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 047-00062
- Practice address
- 130 Fisher Rd Ste 1-6
Berlin, VT 05602-9000 - Phone
- (802) 272-5919
- Fax
- (802) 223-7444
- NPI assigned
- Aug 31, 2006
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047-00062 | VT | Primary |
Addresses
Primary practice location
130 Fisher Rd Ste 1-6
Berlin, VT 05602-9000
Mailing address
2559 Eagle Peak Rd
West Brookfield, VT 05060-9794
Phone (802) 272-5919
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010122 | Medicaid | VT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 047-00062 | VT | MD | Clinical Psychologist |
Interoperability endpoints
- lthompson235870@direct.uvmhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336259365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2559 EAGLE PEAK RD",
"city": "WEST BROOKFIELD",
"state": "VT",
"postal_code": "050609794",
"telephone_number": "802-272-5919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 FISHER RD STE 1-6",
"city": "BERLIN",
"state": "VT",
"postal_code": "056029000",
"telephone_number": "802-272-5919",
"fax_number": "802-223-7444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "LAURANCE",
"name_prefix": "Mr.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "047-00062",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1010122",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Berlin, 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.