Active NPI
Edward Thorndike, MA, AAP
- Mental Health Counselor
- Stowe, VT
National Provider Identifier
1669965554
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 097.0112163
- Practice address
- 56 Old Farm Rd
Stowe, VT 05672-4434 - Phone
- (802) 578-0184
- NPI assigned
- Jun 14, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 097.0112163 | VT | Primary |
Addresses
Primary practice location
56 Old Farm Rd
Stowe, VT 05672-4434
Mailing address
4 Wood Rd
Stowe, VT 05672-5355
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097.0112163 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528934400000",
"number": "1669965554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 WOOD RD",
"city": "STOWE",
"state": "VT",
"postal_code": "056725355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 OLD FARM RD",
"city": "STOWE",
"state": "VT",
"postal_code": "056724434",
"telephone_number": "802-578-0184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNDIKE",
"first_name": "EDWARD",
"credential": "MA, AAP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-06-14",
"last_updated": "2018-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "097.0112163",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stowe, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.