STATE OF VERMONT (NPI# 1215017678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215017678 |
| Entity Type | Organization |
| Organization Name | STATE OF VERMONT |
| Other Organization Name | VERMONT STATE HOSPITAL |
| Practice Address |
103 South Main Street Waterbury VT 05671-9800 |
| Practice Telephone | 8022413009 |
| Practice Fax Number | 8022411439 |
| Mailing Telephone | 8022413009 |
| Mailing Fax Number | 8022411439 |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2008-04-23 |
| Authorized Official Name | MS. TERRY ROWE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8022413100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 474002 | 05 | |
| VT | 474003 | 05 | |
| VT | VT4000 | 05 |
| Other Name | Type Code |
|---|---|
| Vermont State Hospital | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518394212 | State of Vermont | Community Based Residential Treatment Facility, Mental Illness | 1076 Us Rte 2, Middlesex, VT 05633-7801 | 2013-09-26 |
| 1215151410 | State of Vermont | Clinical Medical Laboratory | Vermont Public Health Laboratory, 359 South Park Drive, Colchester, VT 05446 | 2007-04-12 |
| 1164542361 | State of Vermont | Durable Medical Equipment & Medical Supplies | 108 Cherry St, Burlington, VT 05401-4295 | 2007-03-30 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | STATE OF VERMONT - YOUTH CONSERVATION CORPS, INC. | 1949 East Main St., Richmond, VT 05477 |
| Vermont Business Registrations | STATE OF VERMONT BUSINESS CARD EXCHANGE | Pob 110, So. Barre, VT 05670 |
| Street Address |
103 SOUTH MAIN STREET |
| City | WATERBURY |
| State | VT |
| Zip Code | 05671-9800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174668396 | Richard G Munson | Psychiatry & Neurology | 103 South Main Street, Vermont State Hospital, Waterbury, VT 05671-2501 | 2007-02-21 |
| 1467504928 | Kathleen Daye | General Practice | 103 South Main Street, Vermont State Hospital, Waterbury, VT 05671-2501 | 2007-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487909974 | Vocational Rehabiliation Vermont | Durable Medical Equipment & Medical Supplies | 103 S Main St Weeks Bldg, Waterbury, VT 05671-0001 | 2012-07-20 |
| 1346445988 | Thomas Albin Sturm | Pharmacist | 820 Stowe Waterbury Rd, Waterbury, VT 05671-0001 | 2007-06-15 |
| 1346339702 | State of Vermont - Department for Children & Families | Community/Behavioral Health | 103 S Main St, Osgood I, Waterbury, VT 05671-9800 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861024 | Staywell Health Care Inc | Clinic/Center | 160 Robbins St Ste 2, Waterbury, CT 06708-2652 | 2020-11-03 |
| 1881294056 | Keyndra Lewis | Marriage & Family Therapist | 116 Courtland Ave, Waterbury, CT 06705-2412 | 2020-10-27 |
| 1093314940 | Zoada Sahn | Occupational Therapy Assistant | 140 Fulkerson Dr Apt 12e, Waterbury, CT 06708-1441 | 2020-10-21 |
| 1598372724 | Vasta Pt Waterbury LLC | Physical Therapist | 80 S Main St Ste 6, Waterbury, VT 05676-1540 | 2020-10-01 |
| 1992302160 | Heartlinks Aba LLC | Behavioral Analyst | 65 Cables Ave Apt 2, Waterbury, CT 06710-1644 | 2020-10-01 |
| 1639786072 | Cassandra Lynn Manger | Social Worker | 255 Bank St, Waterbury, CT 06702-2219 | 2020-09-29 |
| 1033725510 | Bianca Mcdaniel | Counselor | 1652 Meriden Rd Apt 22, Waterbury, CT 06705-3922 | 2020-09-20 |
| 1164038766 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 344 Reidville Dr, Waterbury, CT 06705-2638 | 2020-09-18 |
| 1609481639 | Gresi Kello | Physician Assistant | 506 Frost Rd, Waterbury, CT 06705-2304 | 2020-09-15 |
| 1396359212 | Puja Senning | Counselor | 372 Pollander Rd, Waterbury, VT 05676-9428 | 2020-09-08 |
| Find all providers in WATERBURY | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659905313 | Restart Health and Wellness LLC | Psychiatry & Neurology | 1336 W Main St Ste 2a, Waterbury, CT 06708-3122 | 2020-03-02 |
| 1538206800 | John Chardavoyne | Psychiatry & Neurology | Waterbury Outpatient Clinic, 95 Scovill Street, Waterbury, CT 06706 | 2007-01-30 |
| 1821169582 | Jeffrey H Boyd Md & Associates PC | Psychiatry & Neurology | 969 West Main St, 2nd Floor, Waterbury, CT 06708 | 2006-11-13 |
| 1063599637 | Judith Karen Carlson | Psychiatry & Neurology | 55 West Main Street Suite 410, Western Connecticut Mental Health Network, Waterbury, CT 06702 | 2006-11-01 |
| 1437234218 | Thomas A Simpatico | Psychiatry & Neurology | South Main Street, Waterbury, VT 05676 | 2006-10-27 |
| 1659307106 | Kunjathan Thankappan | Psychiatry & Neurology | 100 Jefferson Sq, Waterbury, CT 06706-1109 | 2006-06-25 |
| 1578516597 | Azhar Imam | Psychiatry & Neurology | 100 Jefferson Square, Waterbury, CT 06706-1253 | 2006-05-19 |
| 1700852787 | George Robert C Amilo | Psychiatry & Neurology | Waterbury Hospital, 64 Robbins Street, Waterbury, CT 06708 | 2006-02-28 |
| 1780660134 | Lori Sobel | Psychiatry & Neurology | 4 Midland Ave, Connecticut Counseling, Waterbury, CT 06705 | 2005-12-19 |
| 1083697114 | Jeffrey Howard Boyd | Psychiatry & Neurology | 969 W Main St, Waterbury, CT 06708-2653 | 2005-11-22 |
| Find all providers in WATERBURY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.