Lauren Jeanne Johnson, PSYCHOLOGIST-MASTER
Individual provider Active NPI Clinical Child & Adolescent Psychologist · Morrisville, VT
NPI 1548290992 · NPPES record last updated May 8, 2018
Key facts
- NPI
- 1548290992
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Child & Adolescent Psychologist 103TC2200X
- License
- 047-0000676 (VT)
- Practice address
- 607 Washinton Highway
Morrisville, VT 05661-8652 - Phone
- (802) 888-8320
- Fax
- (802) 888-8136
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000125 | VT | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 000125 | VT | |
| Clinical Child & Adolescent Psychologist | 103TC2200X | 047-0000676 | VT | Yes |
Addresses
Primary practice location
607 Washinton Highway
Morrisville, VT 05661-8652
Mailing address
6213 VT Route 14
Craftsbury Common, VT 05827-9500
Phone (802) 279-4636
Other practice location 1
609 Washington Hwy
Morrisville, VT 05661-8652
Phone (802) 888-8320
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OVN1866 | Medicaid | VT |
Other providers in Morrisville, VT
- Deanna Hurley
- Grace Hurley
- Katina Idol
- Patricia I Jaqua
- Benjamin Robert Jefka
- Stephanie Johnson
- Alexander C. Johnston
- Heather Marie Jones
- John Kaeding
- Kate Donnally Licsw, LLC
All providers in Morrisville, VT · Clinical Child & Adolescent Psychologist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 8, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.