Active NPI
Virginia Wells Logan, M.A.
- Psychologist
- Middlebury, VT
National Provider Identifier
1831412915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 047-0000348
- Practice address
- 64 Main St
Middlebury, VT 05753-1426 - Phone
- (802) 989-3743
- NPI assigned
- Mar 3, 2010
- Last updated
- Mar 3, 2010
- 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 | 047-0000348 | VT | Primary |
Addresses
Primary practice location
64 Main St
Middlebury, VT 05753-1426
Mailing address
206 Gooseneck Bend Rd
Weybridge, VT 05753-9635
Phone (802) 989-3743
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
| License | State | Type | Specialty |
|---|---|---|---|
| 047-0000348 | VT | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267574400000",
"number": "1831412915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "206 GOOSENECK BEND RD",
"city": "WEYBRIDGE",
"state": "VT",
"postal_code": "057539635",
"telephone_number": "802-989-3743"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 MAIN ST",
"city": "MIDDLEBURY",
"state": "VT",
"postal_code": "057531426",
"telephone_number": "802-989-3743"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOGAN",
"first_name": "VIRGINIA",
"middle_name": "WELLS",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-03",
"last_updated": "2010-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "VT",
"license": "047-0000348",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middlebury, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.