Diane M Tetrault, MA LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0680000627 Issued in VT

Practice address

138 Main St
Montpelier, VT 05602

Phone

(802) 229-1643

Fax

(802) 229-1643

NPI assigned

Feb 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861533119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 MAIN ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "05602",
            "telephone_number": "802-229-1643",
            "fax_number": "802-229-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 MAIN ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "05602",
            "telephone_number": "802-229-1643",
            "fax_number": "802-229-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETRAULT",
        "first_name": "DIANE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "0680000627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL H",
            "identifier": "2316710",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MAGELEN",
            "identifier": "00068835",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011810",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST VALUE OPTIONS",
            "identifier": "581232",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "389311",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Suter, L.I.C.S.W.
• Cynthia Anne Swartz, M.D.
• Susan L Swindell, LPMA
• Sylvia Gaboriault Wellness Services LLC
• Michael Taub, O.D.
• Amber R. Thomas, MS, CADC
• Heidi Louise Thompson, M.A.
• Ronald Edward Thompson, PSY MA
• Tamella K. Thygesen, AS
• Laura Timmkreitzer

• Mental Health Counselor in Montpelier, VT
• Providers in Montpelier, VT by specialty
• Mental Health Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.