Individual provider Active NPI

John Pacheco, LPMA

  • Psychologist
  • Montpelier, VT
National Provider Identifier
1376911669
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
73 Main St
Montpelier, VT 05602-2932
Phone
(802) 225-8355
Fax
(802) 223-8005
NPI assigned
Sep 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Psychologist 103T00000X Primary

Addresses

Primary practice location

73 Main St
Montpelier, VT 05602-2932

Mailing address

PO Box 647
Montpelier, VT 05601-0647
Phone (802) 229-1399

Other practice location 1

65 Portland St
Morrisville, VT 05661-7403
Phone (802) 888-0079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240925004065 VT Practitioner - Mental Health Counselor 0547701948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

73 Main St
Montpelier, VT 05602-2932
Phone (802) 225-8355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Washington County Mental Health Services, Inc. Mental Health CurrentSince Aug 12, 2024 Accepting new patients
Washington County Mental Health Services, Inc. Mental Health CurrentSince Aug 12, 2024 Accepting new patients

Locations

174 Hospital Loop
Berlin, VT 05602
Phone (802) 223-6328

Organizations & group practices 2

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1376911669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 647",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056010647",
            "telephone_number": "802-229-1399",
            "fax_number": "802-223-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 MAIN ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056022932",
            "telephone_number": "802-225-8355",
            "fax_number": "802-223-8005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Portland St",
            "address_purpose": "LOCATION",
            "city": "Morrisville",
            "state": "VT",
            "postal_code": "056617403",
            "country_code": "US",
            "telephone_number": "802-888-0079",
            "fax_number": "802-888-0116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PACHECO",
        "first_name": "JOHN",
        "credential": "LPMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-09-03",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montpelier, VT

Sources for this page

Verify at the official NPI Registry.