Organization Active NPI

Dr Sara Clements LLC

  • Psychologist
  • Burlington, VT
National Provider Identifier
1568865236
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
048.0072012 Issued in VT
Legal business name
DR SARA CLEMENTS LLC
Practice address
125 College St
1
Burlington, VT 05401-8444
Phone
(802) 497-0363
NPI assigned
Oct 8, 2014
Last updated
Oct 8, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2014

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

Authorized official

Name
Dr. Sara Marie Clements, PSYDNPI 1922439348
Title
Clinical Psychologist Doctorate
Phone
(802) 497-0363

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 048.0072012 VT Primary

Addresses

Primary practice location

125 College St
1
Burlington, VT 05401-8444

Mailing address

125 College St
1
Burlington, VT 05401-8444
Phone (802) 497-0363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150318000754 VT Part B Supplier - Clinic/Group Practice 7416274162 Receives reassigned benefits from 1 practitioner
Practice locations: Colchester, VT

National Provider Directory

National Provider Directory

Locations

125 College St
Ste 1
Burlington, VT 05401
Phone (802) 338-6375

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1568865236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 COLLEGE ST",
            "address_2": "1",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018444",
            "telephone_number": "802-497-0363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 COLLEGE ST",
            "address_2": "1",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018444",
            "telephone_number": "802-497-0363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SARA CLEMENTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "CLEMENTS",
        "authorized_official_first_name": "SARA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST DOCTORATE",
        "authorized_official_telephone_number": "802-497-0363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "048.0072012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.