Individual provider Active NPI

Steven B Mann, PHD

  • Clinical Psychologist
  • Manchester Center, VT
National Provider Identifier
1699743799
Registry record updated Apr 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0480000217 Issued in VT
Practice address
3505 Richville Rd
Ste B
Manchester Center, VT 05255-9812
Phone
(802) 865-4500
Fax
(802) 865-4800
NPI assigned
Mar 14, 2006
Last updated
Apr 23, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0480000217 VT Primary

Addresses

Primary practice location

3505 Richville Rd
Ste B
Manchester Center, VT 05255-9812

Mailing address

3505 Richville Rd
Ste B
Manchester Center, VT 05255-9812
Phone (802) 865-4500

Other identifiers 1

IdentifierTypeStateIssuer
0006573MedicaidVT

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20050407000071 VT Practitioner - Clinical Psychologist 2264489699 Practice locations: Manchester Center, VT; Middlebury, VT; Rutland, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3505 Richville Rd
Suite B
Manchester Center, VT 05255-9812
Phone (802) 865-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0480000217VTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461369600000",
    "number": "1699743799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 RICHVILLE RD",
            "address_2": "STE B",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052559812",
            "telephone_number": "802-865-4500",
            "fax_number": "802-865-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 RICHVILLE RD",
            "address_2": "STE B",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052559812",
            "telephone_number": "802-865-4500",
            "fax_number": "802-865-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "STEVEN",
        "middle_name": "B",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2016-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "0480000217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006573",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester Center, VT

Sources for this page

Verify at the official NPI Registry.