Active NPI
Larry Hall, MA
- Psychologist
- Burlington, VT
National Provider Identifier
1609997444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 047-0000503
- Practice address
- 1 Steele St
#113
Burlington, VT 05401-6204 - Phone
- (802) 862-2383
- Fax
- (802) 862-2383
- NPI assigned
- Apr 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 047-0000503 | VT | Primary |
Addresses
Primary practice location
1 Steele St
#113
Burlington, VT 05401-6204
Mailing address
1 Steele St
#113
Burlington, VT 05401-6204
Phone (802) 862-2383
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003291 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047-0000503 | VT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1609997444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 STEELE ST",
"address_2": "#113",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054016204",
"telephone_number": "802-862-2383",
"fax_number": "802-862-2383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 STEELE ST",
"address_2": "#113",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054016204",
"telephone_number": "802-862-2383",
"fax_number": "802-862-2383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALL",
"first_name": "LARRY",
"name_prefix": "Mr.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "047-0000503",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1003291",
"state": "VT"
}
],
"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 Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.