Elizabeth Sprague, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

048-0000797 Issued in VT

Practice address

1 Kennedy Dr Ste L8
South Burlington, VT 05403-7165

Phone

(802) 860-1002

Fax

(802) 658-8494

NPI assigned

May 11, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1972718146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR STE L8",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037165",
            "telephone_number": "802-860-1002",
            "fax_number": "802-658-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR STE L8",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037165",
            "telephone_number": "802-860-1002",
            "fax_number": "802-658-8494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "VT",
            "license": "048-0000797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD ID",
            "identifier": "59431",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009110",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Spence, RN CDE
• Karen Lindemann Sperry, DDS
• Spinal Care and Decompression Center of VT PLLC
• Pete Hunter Spitellie, M.D.
• Linn Spitzer
• Jessica Lynn Stadtmauer, N.D.
• Michael Stadtmauer, N.D., L.AC.
• Mary Armstrong Stanley, MD
• McKenzie L Stannard, PHARM.D
• Kathryn Stanton, DPT

• Psychologist in South Burlington, VT
• Providers in South Burlington, VT by specialty
• Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.