NPIMap

Organization Active NPI

Lisa M. Stephen PH.D., PC

  • Clinical Psychologist
  • Shelburne, VT
National Provider Identifier
1952799694
Registry record updated Jul 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
048-0000778 Issued in VT
Legal business name
LISA M. STEPHEN PH.D., PC
Practice address
145 Pine Haven Shores Rd Ste 2294
Shelburne, VT 05482-7703
Phone
(802) 355-9299
Fax
(802) 419-3399
NPI assigned
Jan 5, 2015
Last updated
Jul 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2025

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

Authorized official

Name
Dr. Lisa Mary Stephen, PH.D.NPI 1699862342
Title
Psychologist
Phone
(802) 355-9299

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 048-0000778 VT Primary

Addresses

Primary practice location

145 Pine Haven Shores Rd Ste 2294
Shelburne, VT 05482-7703

Mailing address

PO Box 302
Jericho, VT 05465-0302
Phone (802) 355-9299

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160211000110 VT Part B Supplier - Clinic/Group Practice 2365746393 Receives reassigned benefits from 1 practitioner
Practice locations: Shelburne, VT

National Provider Directory

National Provider Directory

Locations

145 Pine Haven Shores Rd
Ste 2294
Shelburne, VT 05482
Phone (802) 355-9299

135 Allen Brook Ln
Ste 204
Williston, VT 05495
Phone (802) 355-9299

37 Talcott Rd
Ste 100
Williston, VT 05495
Phone (802) 355-9299

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1420416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1952799694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 302",
            "city": "JERICHO",
            "state": "VT",
            "postal_code": "054650302",
            "telephone_number": "802-355-9299",
            "fax_number": "802-419-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PINE HAVEN SHORES RD STE 2294",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827703",
            "telephone_number": "802-355-9299",
            "fax_number": "802-419-3399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M. STEPHEN PH.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-05",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "STEPHEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "802-355-9299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelburne, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.