Michele Ann Beaulieu

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

8064708 Issued in VT

Practice address

78 S Main St
Rutland, VT 05701-4594

Phone

(802) 775-2381

NPI assigned

May 16, 2024

Last updated

Oct 30, 2024By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1715817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1639928153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1718 BELGO RD APT 1",
            "city": "CASTLETON",
            "state": "VT",
            "postal_code": "057355602",
            "telephone_number": "207-831-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78 S MAIN ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014594",
            "telephone_number": "802-775-2381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAULIEU",
        "first_name": "MICHELE",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-16",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "VT",
            "license": "8064708",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "VT",
            "license": "8064708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne G Baylock, ADV PRACTICE RN
• Kate Elizabeth Beaman-Martinez
• Sarah C Beard, LICSW
• Beauchamp & O'Rourke Inc.
• Kayla Beauchamp
• Devin James Beayon
• Jason Mark Beckta, M.D., PH.D.
• Brie E Beckwith, DPT
• Rebecca Lynn Beecroft, AGPCNP-BC, PMHNP-BC
• Mary M Beerworth, M.D.

• Cognitive & Behavioral Psychologist in Rutland, VT
• Providers in Rutland, VT by specialty
• Cognitive & Behavioral Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.