Individual provider Active NPI

Milton J Marasch, PH.D.

  • Clinical Psychologist
  • Burlington, VT
National Provider Identifier
1427053586
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
717 Issued in VT
Practice address
148 College St Ste 202a
Burlington, VT 05401-8681
Phone
(802) 985-9191
Fax
(802) 985-8181
NPI assigned
Jun 16, 2005
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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 717 VT Primary

Addresses

Primary practice location

148 College St Ste 202a
Burlington, VT 05401-8681

Mailing address

145 Pine Haven Shores Rd Ste 1011
Shelburne, VT 05482-7812
Phone (802) 985-9191

Other identifiers 4

IdentifierTypeStateIssuer
2033041OtherVTCIGNA
39072OtherVTBCBS
0VN2151MedicaidVT
324707OtherVTMVP

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
I20060505000497 VT Practitioner - Clinical Psychologist 0749291797 Practice locations: Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

148 College St
Suite 202a
Burlington, VT 05401-8476
Phone (802) 985-9191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
717VTMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Solid Ground Psychiatry PLC PastSince Aug 1, 2022 Accepting new patients
Counseling Connection Training Institute, PLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1427053586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 PINE HAVEN SHORES RD STE 1011",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827812",
            "telephone_number": "802-985-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 COLLEGE ST STE 202A",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018681",
            "telephone_number": "802-985-9191",
            "fax_number": "802-985-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARASCH",
        "first_name": "MILTON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2033041",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "39072",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN2151",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "324707",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.