Mary Jean Sadlak, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

0480000505 Issued in VT

Practice address

160 Benmont Ave
Suite 20
Bennington, VT 05201-1873

Phone

(802) 442-3520

Fax

(802) 447-3392

NPI assigned

Dec 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mary Jean Sadlak PHD PC

  • Clinical Psychologist
  • Bennington, VT
  • NPI 1013301324
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1425600000000",
    "number": "1659435147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 BENMONT AVE",
            "address_2": "SUITE 20",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011873",
            "telephone_number": "802-442-3520",
            "fax_number": "802-447-3392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BENMONT AVE",
            "address_2": "SUITE 20",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011873",
            "telephone_number": "802-442-3520",
            "fax_number": "802-447-3392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADLAK",
        "first_name": "MARY JEAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2015-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VT",
            "license": "0480000505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN0349",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Bennington, VT
• Providers in Bennington, VT by specialty
• Counseling Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2015; 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.