Active NPI
M Corbin Gould, LPMA
- Psychologist
- Montpelier, VT
National Provider Identifier
1780760314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 047-0000702
- Practice address
- 149 State Street - the Redfield House
Montpelier, VT 05602-0560 - Phone
- (802) 223-4111
- NPI assigned
- Oct 27, 2006
- Last updated
- Aug 6, 2020
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 047-0000702 | VT | Primary |
Addresses
Primary practice location
149 State Street - the Redfield House
Montpelier, VT 05602-0560
Mailing address
149 State Street
Montpelier, VT 05602
Phone (802) 223-4111
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008048 | Medicaid | VT | |
| 614320 | Other | VT | MVP PROVIDER # |
| 470000702 | Medicaid | VT | |
| 062-58242 | Other | VT | BC/BS # |
| 776927000 | Other | VT | MAGELLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047-0000702 | VT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596672000000",
"number": "1780760314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "149 STATE STREET",
"city": "MONTPELIER",
"state": "VT",
"postal_code": "05602",
"telephone_number": "802-223-4111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "149 STATE STREET - THE REDFIELD HOUSE",
"city": "MONTPELIER",
"state": "VT",
"postal_code": "056020560",
"telephone_number": "802-223-4111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOULD",
"first_name": "M",
"middle_name": "CORBIN",
"name_prefix": "Ms.",
"credential": "LPMA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2020-08-06",
"certification_date": "2020-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "047-0000702",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1008048",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MVP PROVIDER #",
"identifier": "614320",
"state": "VT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "470000702",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS #",
"identifier": "062-58242",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "776927000",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montpelier, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.