Individual provider Active NPI

Judy Beryl Greenberg, M.A.

  • Counseling Psychologist
  • Brattleboro, VT
National Provider Identifier
1801088828
Registry record updated Aug 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
417 Issued in VT
Practice address
167 Main St
Brattleboro, VT 05301-7128
Phone
(802) 254-7395
NPI assigned
Aug 14, 2007
Last updated
Aug 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X 417 VT Primary

Addresses

Primary practice location

167 Main St
Brattleboro, VT 05301-7128

Mailing address

PO Box 6372
Brattleboro, VT 05302-6372
Phone (802) 254-7395

Other identifiers 2

IdentifierTypeStateIssuer
6007OtherVTBLUE CROSS BLUE SHIELD
1004848MedicaidVT

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
417VTMDCounseling Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187049600000",
    "number": "1801088828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6372",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053026372",
            "telephone_number": "802-254-7395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 MAIN ST",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017128",
            "telephone_number": "802-254-7395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENBERG",
        "first_name": "JUDY",
        "middle_name": "BERYL",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-14",
        "last_updated": "2007-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "VT",
            "license": "417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "6007",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004848",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; 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.