NPIMap

Organization Active NPI

Vermont Psychological Services: Leitenberg Center for Evidence-Based P

  • Clinical Psychologist
  • Burlington, VT
National Provider Identifier
1598837593
Registry record updated Feb 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
VERMONT PSYCHOLOGICAL SERVICES: LEITENBERG CENTER FOR EVIDENCE-BASED P
Practice address
2 Colchester Avenue
Burlington, VT 05405-1764
Phone
(802) 656-2661
Fax
(802) 656-3485
NPI assigned
Nov 14, 2006
Last updated
Feb 3, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2017

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

Authorized official

Name
Kathleen B. Kennedy, PH.D.NPI 1902857048
Title
Acting Director
Phone
(802) 656-2661

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2 Colchester Avenue
Burlington, VT 05405-1764

Mailing address

2 Colchester Avenue
Burlington, VT 05405-1764
Phone (802) 656-2661

Other names 1

  • Behavior Therapy & Psychotherapy Center Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050411000605 VT Part B Supplier - Clinic/Group Practice 0244277333 Receives reassigned benefits from 2 practitioners
Practice locations: Burlington, VT

National Provider Directory

National Provider Directory

Locations

2 Colchester Ave
Burlington, VT 05405
Phone (802) 656-2661

Practitioners & affiliated clinicians

Practitioners 46

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.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1598837593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 COLCHESTER AVENUE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054051764",
            "telephone_number": "802-656-2661",
            "fax_number": "802-656-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLCHESTER AVENUE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054051764",
            "telephone_number": "802-656-2661",
            "fax_number": "802-656-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERMONT PSYCHOLOGICAL SERVICES: LEITENBERG CENTER FOR EVIDENCE-BASED P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "KENNEDY",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "ACTING DIRECTOR",
        "authorized_official_telephone_number": "802-656-2661",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Behavior Therapy & Psychotherapy Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Feb 3, 2017; 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.