Takuya Minami

Primary specialty

PsychologistTaxonomy code 103T00000X

License

048.0135139 Issued in VT

Practice address

175 Western Ave
Brattleboro, VT 05301-6950

Phone

(802) 416-0160

NPI assigned

Mar 27, 2007

Last updated

Jun 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749254400000",
    "number": "1639297344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 WESTERN AVE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016950",
            "telephone_number": "802-416-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 WESTERN AVE",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016950",
            "telephone_number": "802-416-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINAMI",
        "first_name": "TAKUYA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-27",
        "last_updated": "2025-06-07",
        "certification_date": "2025-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "UT",
            "license": "5729247-2501",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "048.0135139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margrit C. Mikulis, ND
• Casey Dee Milkey, AUD
• Alaina Millard, BA MA
• Andrew Chapman Miller, RPH
• Angela P. Miller, FNP-BC
• Emily Regina Mleczko
• Esther Barbara Moerth, DOM,LAC,DIPL.CH
• Anne Cloutier Montgomery, PA
• Montpelier Pharmacy Inc (Brattleboro Pharmacy)
• Montshire Brattleboro PC (Montshire Pediatric Dentistry)

• Psychologist in Brattleboro, VT
• Providers in Brattleboro, VT by specialty
• Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.