Northeast Kingdom Trauma Intensives

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

NORTHEAST KINGDOM TRAUMA INTENSIVES

Practice address

293 Pearl St Ste 101
St Johnsbury, VT 05819-5641

Phone

(802) 327-5902

NPI assigned

Sep 28, 2022

Last updated

Sep 28, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Lynn Keith, PHD, LPC, LCHMC, NCCNPI 1962843532

Title

Owner/Psychotherapist

Phone

(802) 327-5902

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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.

• Jennifer Keith, LPC

  • Professional Counselor
  • Lexington, VA
  • NPI 1962843532
  NPD Authorized official

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1629792114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 CHESTERFIELD HOLW",
            "city": "LYNDONVILLE",
            "state": "VT",
            "postal_code": "058518530",
            "telephone_number": "540-797-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 PEARL ST STE 101",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058195641",
            "telephone_number": "802-327-5902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST KINGDOM TRAUMA INTENSIVES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "802-327-5902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LPC, LCHMC, NCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Country Chiropractic Center PLLC
• North East Kingdom Community Action, Inc.
• Northeast Kingdom Council on Aging
• Northeast Kingdom Healthcare Collaborative, LLC
• Northeast Kingdom Occupational Therapy
• Northeastern Vermont Regional Hospial
• Northeastern Vermont Regional Hospital
• Northeastern Vermont Regional Hospital Dietary Clinic
• Northeastern Vermont Regional Hospital Inc (NVRH Mental Health Group)
• Northeastern Vermont Regional Hospital Inc (NVRH Kingdom Internal Medicine)

• Mental Health Clinic/Center (Including Community Mental Health Center) in St Johnsbury, VT
• Providers in St Johnsbury, VT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.