Judith Vanderryn, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

048.0134642 Issued in VT

Practice address

595 Dorset St Ste 2
South Burlington, VT 05403-6240

Phone

(802) 651-8999

Fax

(802) 651-8997

NPI assigned

Sep 14, 2006

Last updated

Jan 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Phoenix Psychotherapy LLC

  • Psychologist
  • South Burlington, VT
  • NPI 1114348166
  Medicare reassignment Authorized official
• Durango Psychological Associates, LLC

  • Health Service Psychologist
  • Durango, CO
  • NPI 1477607554
  NPD (past)

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1760587323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "VERGENNES",
            "state": "VT",
            "postal_code": "054910125",
            "telephone_number": "802-651-8999",
            "fax_number": "802-651-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 DORSET ST STE 2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036240",
            "telephone_number": "802-651-8999",
            "fax_number": "802-651-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERRYN",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048.0134642",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "2051",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Vermont Medical Center Inc
• Upward Mobility
• Peter Van Buren
• Katherine Anna Van Wagner, MSW, LICSW
• Kristen Lynn Vance, NCBTMB
• Dorothy F Vangerbig, PA-C
• Allison Vannorden, MS
• Vasta Physical Therapy, Inc
• Vermont Catholic Charities, Inc
• Vermont Center for Integrative Therapy, LLC

• Clinical Psychologist in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Clinical Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.