Individual provider Active NPI

Kathryn Rick, PH.D.

  • Psychologist
  • Williston, VT
National Provider Identifier
1902161698
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
048.0000631 Issued in VT
Practice address
28 Park Ave
Suite 110
Williston, VT 05495-9701
Phone
(802) 878-0550
Fax
(802) 878-0440
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 048.0000631 VT Primary

Addresses

Primary practice location

28 Park Ave
Suite 110
Williston, VT 05495-9701

Mailing address

7 Lamoille St
Essex Junction, VT 05452-3729
Phone (802) 871-5635

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200403002413 VT Practitioner - Clinical Psychologist 6305275884 Practice locations: South Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

56 W Twin Oaks Ter
Suite 3
South Burlington, VT 05403-7138
Phone (802) 777-3035

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341792000000",
    "number": "1902161698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 LAMOILLE ST",
            "city": "ESSEX JUNCTION",
            "state": "VT",
            "postal_code": "054523729",
            "telephone_number": "802-871-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PARK AVE",
            "address_2": "SUITE 110",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959701",
            "telephone_number": "802-878-0550",
            "fax_number": "802-878-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICK",
        "first_name": "KATHRYN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2012-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "048.0000631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

Verify at the official NPI Registry.