Doctor Elizabeth Jensen Psychiatry Professional Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

042.0013202 Issued in VT

Legal business name

DOCTOR ELIZABETH JENSEN PSYCHIATRY PROFESSIONAL CORPORATION

Doing business as

Jensen Psychiatry

Practice address

27 Rye Circle
South Burlington, VT 05483

Phone

(802) 777-8703

Fax

(802) 654-9155

NPI assigned

Apr 29, 2016

Last updated

Apr 29, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Elizabeth Ann Jensen, MD, PHD

Title

President

Phone

(802) 777-8703

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jensen Psychiatry Doing business as

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1710332549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 666",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054820666",
            "telephone_number": "802-777-8703",
            "fax_number": "802-654-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 RYE CIRCLE",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "05483",
            "telephone_number": "802-777-8703",
            "fax_number": "802-654-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR ELIZABETH JENSEN PSYCHIATRY PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-777-8703",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, PHD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VT",
            "license": "042.0013202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NPI",
            "identifier": "1740440122",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025437",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jensen Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leyla Dickason, RN
• Heather Lynn Diederich, D.C.
• Shon Christopher Diguglielmo, D.D.S.
• Cara Dimasi, N.P.
• Mark Chipman Dobson, DTR
• Susan Dodge, P.T.
• Sara Doll, M.S. ED. CCC-SLP
• Elizabeth Donahue, MSW, LICSW
• Dorset Street Dermatology
• Dorset Street Family Dental PLC

• Psychiatry Physician in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Psychiatry Physician in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.

Verify at the official NPI Registry.