Active NPI
Beth Anne Wermuth, MA
- Clinical Psychologist
- Shelburne, VT
National Provider Identifier
1710099791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 047-0000639
- Practice address
- 145 Pine Haven Shores Rd
Suite 2032
Shelburne, VT 05482-7703 - Phone
- (802) 864-4513
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047-0000639 | VT | Primary |
Addresses
Primary practice location
145 Pine Haven Shores Rd
Suite 2032
Shelburne, VT 05482-7703
Mailing address
417 Pettingill Rd
Essex Junction, VT 05452-2669
Phone (802) 864-4513
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1006526 | Medicaid | VT |
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 |
|---|---|---|---|
| 047-0000639 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1710099791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 PETTINGILL RD",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054522669",
"telephone_number": "802-864-4513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 PINE HAVEN SHORES RD",
"address_2": "SUITE 2032",
"city": "SHELBURNE",
"state": "VT",
"postal_code": "054827703",
"telephone_number": "802-864-4513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WERMUTH",
"first_name": "BETH",
"middle_name": "ANNE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "047-0000639",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1006526",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shelburne, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.