Brain Injury Alliance of Vermont

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

BRAIN INJURY ALLIANCE OF VERMONT

Practice address

1 Derby LN Ste 2
Waterbury, VT 05676-8926

Phone

(802) 244-3850

Fax

(802) 244-4005

NPI assigned

Jul 5, 2023

Last updated

Jan 10, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jessica Leal

Title

Executive Director

Phone

(802) 244-6850

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1508543174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DERBY LN STE 2",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056768926",
            "telephone_number": "802-244-6850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DERBY LN STE 2",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056768926",
            "telephone_number": "802-244-3850",
            "fax_number": "802-244-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN INJURY ALLIANCE OF VERMONT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-05",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "LEAL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-244-6850"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B and J Dental
• Ryan Beaudoin
• Louis Bevacqui
• Christine Cameron Blake, PH.D.
• Merton R. Boardman Sr.
• Carol L Buck-Rolland, NP
• Richard Andrew Burgoyne, M.D.
• Katharina Cahill, PHARM D
• Craig A Cammann, LAC., DAC, DIPL. AC,
• Laurie A. Carcieri, BS

• Case Management Agency in Waterbury, VT
• Providers in Waterbury, VT by specialty
• Case Management Agency in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.