Individual provider Active NPI

Deborah Kelin Smith, M.ED., LADC

  • Psychologist
  • Springfield, VT
National Provider Identifier
1619096302
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
000234 Issued in VT
Practice address
390 River St.
Springfield, VT 05156
Phone
(802) 886-4500
Fax
(802) 886-4520
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 000234 VT Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 000234 VT

Addresses

Primary practice location

390 River St.
Springfield, VT 05156

Mailing address

390 River St.
Springfield, VT 05156
Phone (802) 886-4500

Other identifiers 2

IdentifierTypeStateIssuer
59963OtherVTBLUE CROSS
2190024OtherVTCIGNA

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 Education

State licenses

LicenseStateTypeSpecialty
000234VTMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1619096302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER ST.",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "05156",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 RIVER ST.",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "05156",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELIN SMITH",
        "first_name": "DEBORAH",
        "credential": "M.ED., LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "000234",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000234",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "59963",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2190024",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.