Individual provider Active NPI

Mary-Ellen Giroux, M.A.

  • Clinical Psychologist
  • Essex Junction, VT
National Provider Identifier
1528273851
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
614 Issued in VT
Practice address
67 Lincoln St
Essex Junction, VT 05452-3235
Phone
(802) 878-7126
Fax
(802) 878-9966
NPI assigned
May 11, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 614 VT Primary

Addresses

Primary practice location

67 Lincoln St
Essex Junction, VT 05452-3235

Mailing address

67 Lincoln St
Essex Junction, VT 05452-3235
Phone (802) 878-7126

Other identifiers 1

IdentifierTypeStateIssuer
1007101MedicaidVT

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
I20240422000077 VT Practitioner - Clinical Psychologist 4789023961 Practice locations: Williston, VT

Care Compare profile

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

Practice addresses (Care Compare)

146 Rita Rd
Williston, VT 05495-2026

277 Blair Park Rd
Suite 210
Williston, VT 05495-7885
Phone (802) 878-7126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
614VTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528273851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 LINCOLN ST",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523235",
            "telephone_number": "802-878-7126",
            "fax_number": "802-878-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 LINCOLN ST",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523235",
            "telephone_number": "802-878-7126",
            "fax_number": "802-878-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIROUX",
        "first_name": "MARY-ELLEN",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "614",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007101",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex Junction, VT

Sources for this page

Verify at the official NPI Registry.