Carolyn Edwards Basiliere LLC
Organization Active NPI Clinical Psychologist · Burlington, VT
NPI 1841969482 · NPPES record last updated Sep 8, 2021
Key facts
- NPI
- 1841969482
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- Legal business name
- CAROLYN EDWARDS BASILIERE LLC
- Practice address
- 156 College St Ste 201
Burlington, VT 05401-8423 - Phone
- (802) 657-3647
- Fax
- (802) 860-0183
- NPI assigned
- Sep 8, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Carolyn Edwards Basiliere, PHD
- Title
- Psychologist
- Phone
- (802) 657-3647
Practitioners 1
-
Carolyn Basiliere, PH.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210923003323 | VT | Part B Supplier - Clinic/Group Practice | 0749687325 |
Receives reassigned benefits from 1 practitioner Practice locations: Burlington, VT |
National Provider Directory
Locations
2 Church St
Ste 2D
Burlington, VT 05401
Phone (802) 658-9590
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | Yes |
Addresses
Primary practice location
156 College St Ste 201
Burlington, VT 05401-8423
Mailing address
11 Simpson CT
South Burlington, VT 05403-6326
Phone (802) 657-3647
Other names
- Carolyn Basiliere
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | dr.carolyn@hushmail.com | Direct |
Other providers in Burlington, VT
- Corey Carmichael
- Brendan James Carney
- Elizabeth Royden Carney
- Jan Kirk Carney
- Caroline Tassey PLC
- Richard Bohling Carozza
- Ann Carpenter
- Kelsey Carpenter
- Lauren Carpenter
- Rachel Carpenter
All providers in Burlington, VT · Clinical Psychologist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.