Jacquelyn E. Bode, M.Ed., Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

047.0000269 Issued in VT

Legal business name

JACQUELYN E. BODE, M.ED., INC.

Practice address

73 Center St
Rutland, VT 05701-4046

Phone

(802) 747-3488

Fax

(802) 747-0006

NPI assigned

Sep 15, 2010

Organization subpart

No

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

Authorized official

Name

Mrs. Jacquelyn Ellen Bode, M.ED.

Title

President

Phone

(802) 747-3488

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1730497504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 CENTER ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014046",
            "telephone_number": "802-747-3488",
            "fax_number": "802-747-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 CENTER ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014046",
            "telephone_number": "802-747-3488",
            "fax_number": "802-747-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACQUELYN E. BODE, M.ED., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "BODE",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-747-3488",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "047.0000269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002611",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Rutland, VT
• Providers in Rutland, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2010; 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.