Individual provider Active NPI

Jessica R. Houser, PHD

  • Clinical Psychologist
  • Burlington, VT
National Provider Identifier
1972752269
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
048.0118565 Issued in VT
Practice address
3 Main St
Burlington, VT 05401-5216
Phone
(802) 651-7501
NPI assigned
Sep 11, 2008
Last updated
Aug 23, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Psychologist 103TA0400X 019565 NY
Addiction (Substance Use Disorder) Psychologist 103TA0400X 048.0118565 VT
Clinical Psychologist 103TC0700X 019565 NY
Clinical Psychologist 103TC0700X 048.0118565 VT Primary
Clinical Child & Adolescent Psychologist 103TC2200X 019565 NY
Clinical Child & Adolescent Psychologist 103TC2200X 048.0118565 VT

Addresses

Primary practice location

3 Main St
Burlington, VT 05401-5216

Mailing address

3 Main St
Burlington, VT 05401-5216
Phone (802) 651-7501

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
I20210107001647 VT Practitioner - Clinical Psychologist 3072747468 Practice locations: Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3 Main St
Burlington, VT 05401-5216

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019565NYMDAddiction (Substance Use Disorder) Psychologist
048.0118565VTMDAddiction (Substance Use Disorder) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kathryn Fallin, M.S. Clinical Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1972752269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 MAIN ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015216",
            "telephone_number": "802-651-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MAIN ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015216",
            "telephone_number": "802-651-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUSER",
        "first_name": "JESSICA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "019565",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "048.0118565",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "019565",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048.0118565",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "NY",
            "license": "019565",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "VT",
            "license": "048.0118565",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.