NPIMap

Organization Active NPI

Counseling Service of Addison County

  • Developmental Disabilities Clinic/Center
  • Middlebury, VT
National Provider Identifier
1730218868
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
COUNSELING SERVICE OF ADDISON COUNTY
Practice address
89 Main St
Middlebury, VT 05753-1459
Phone
(802) 388-6751
Fax
(802) 388-8183
NPI assigned
Mar 5, 2007
Last updated
Oct 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Dr. Robert Jimerson, M.D.NPI 1700917077
Title
Medical Director
Phone
(802) 388-6751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU Primary

Addresses

Primary practice location

89 Main St
Middlebury, VT 05753-1459

Mailing address

89 Main St
Middlebury, VT 05753-1459
Phone (802) 388-6751

Other identifiers 1

IdentifierTypeStateIssuer
6040011MedicaidVT

National Provider Directory

National Provider Directory
Tax ID family
Counseling Service of Addison County Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1730218868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 MAIN ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531459",
            "telephone_number": "802-388-6751",
            "fax_number": "802-388-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 MAIN ST",
            "city": "MIDDLEBURY",
            "state": "VT",
            "postal_code": "057531459",
            "telephone_number": "802-388-6751",
            "fax_number": "802-388-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNSELING SERVICE OF ADDISON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "JIMERSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "802-388-6751",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6040011",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.