Individual provider Active NPI

Mark Alan Margolis, LP

  • Psychologist
  • Burlington, VT
National Provider Identifier
1578892089
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
047-0052692 Issued in VT
Practice address
1138 Pine St
Burlington, VT 05401-5353
Phone
(802) 488-6000
Fax
(802) 488-6919
NPI assigned
Dec 11, 2009
Last updated
Apr 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 047-0052692 VT Primary

Addresses

Primary practice location

1138 Pine St
Burlington, VT 05401-5353

Mailing address

102 S Winooski Ave
Burlington, VT 05401-7406
Phone (802) 488-6920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
047-0052692VTMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Howard Center Inc CurrentSince Jan 18, 2010 Accepting new patients
Howard Center Inc CurrentSince Jan 18, 2010 Accepting new patients

Locations

102 S Winooski Ave
Burlington, VT 05401
Phone (802) 488-6920

1138 Pine St
Burlington, VT 05401
Phone (802) 488-6600

208 Flynn Ave
Ste 3J
Burlington, VT 05401
Phone (802) 488-6900

300 Flynn Ave
Burlington, VT 05401
Phone (802) 488-6934

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1260489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745884800000",
    "number": "1578892089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S WINOOSKI AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054017406",
            "telephone_number": "802-488-6920",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1138 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015353",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARGOLIS",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-11",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "047-0052692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.