Active NPI
Alicia R Hanifin
- Clinical Psychologist
- Montpelier, VT
National Provider Identifier
1699124388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 120056
- Practice address
- 73 Main St RM 19
Montpelier, VT 05602-2944 - Phone
- (413) 847-1571
- NPI assigned
- Jun 3, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 120056 | VT | Primary |
Addresses
Primary practice location
73 Main St RM 19
Montpelier, VT 05602-2944
Mailing address
73 Main St. Suite 19
Montpelier, VT 05602-2932
Phone (413) 847-1571
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120056 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464912000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464912000000",
"number": "1699124388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "73 MAIN ST. SUITE 19",
"city": "MONTPELIER",
"state": "VT",
"postal_code": "056022932",
"telephone_number": "413-847-1571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "73 MAIN ST RM 19",
"city": "MONTPELIER",
"state": "VT",
"postal_code": "056022944",
"telephone_number": "413-847-1571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANIFIN",
"first_name": "ALICIA",
"middle_name": "R",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-03",
"last_updated": "2016-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "120056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montpelier, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.