Active NPI
Miriam Dena London, PH.D.
- Clinical Psychologist
- South Burlington, VT
National Provider Identifier
1760756381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 467
- Practice address
- 69 Joy Dr Apt E3
South Burlington, VT 05403-6124 - Phone
- (802) 660-2951
- NPI assigned
- Feb 29, 2012
- 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 | 467 | VT | Primary |
Addresses
Primary practice location
69 Joy Dr Apt E3
South Burlington, VT 05403-6124
Mailing address
69 Joy Dr Apt E3
South Burlington, VT 05403-6124
Phone (802) 660-2951
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161107000364 | VT | Practitioner - Clinical Psychologist | 4981982345 | Practice locations: Burlington, VT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1983
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
148 College St
Suite 303
Burlington, VT 05401-8476
Phone (802) 363-1221
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 467 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1760756381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 JOY DR APT E3",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054036124",
"telephone_number": "802-660-2951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "69 JOY DR APT E3",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054036124",
"telephone_number": "802-660-2951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LONDON",
"first_name": "MIRIAM",
"middle_name": "DENA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-29",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; 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.