William David Lax, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

188 Issued in VT

Practice address

352 Orchard St
Brattleboro, VT 05301-4217

Phone

(802) 380-8852

Fax

(802) 488-5714

NPI assigned

Dec 30, 2005

Last updated

Apr 13, 2023By 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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1548247570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 ORCHARD ST",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053014217",
            "telephone_number": "802-380-8852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "352 ORCHARD ST",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053014217",
            "telephone_number": "802-380-8852",
            "fax_number": "802-488-5714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAX",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40426548",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002610",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Laurens
• Saryn T Lauzon
• Mary R Lawlor, CPM, LM
• Portia Lawrence, LCMHC, NCC, R-DMT
• Natasha Lawson
• Diane Leardi, MSW
• Alexis Leclair
• Angela Leclair
• Mandy Leigh Leclaire, RN
• Emma Whiteoak Lee, MACOM

• Clinical Psychologist in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Clinical Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.