Mark Carpenter Mumford, M.A.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

297 Issued in VT

Practice address

Counseling Service of Addison County,Inc.
89 Main Street
Middlebury, VT 05753

Phone

(802) 388-6741

Fax

(802) 388-8183

NPI assigned

Mar 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538290523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COUNSELING SERVICE OF ADDISON COUNTY,INC.",
            "address_2": "89 MAIN STREET",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "05753",
            "telephone_number": "802-388-6741",
            "fax_number": "802-388-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COUNSELING SERVICE OF ADDISON COUNTY,INC.",
            "address_2": "89 MAIN STREET",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "05753",
            "telephone_number": "802-388-6741",
            "fax_number": "802-388-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "MARK",
        "middle_name": "CARPENTER",
        "name_prefix": "Mr.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VT",
            "license": "297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in Middlebury, VT
• Providers in Middlebury, VT by specialty
• Clinical Child & Adolescent Psychologist in Vermont

• 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.

Verify at the official NPI Registry.