CLARA MARTIN CENTER (NPI# 1386710861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386710861 |
| Entity Type | Organization |
| Organization Name | CLARA MARTIN CENTER |
| Practice Address |
11 S Main St Randolph VT 05060-1330 |
| Mailing Address |
Po Box G Randolph VT 05060 |
| Practice Telephone | 8027284466 |
| Practice Fax Number | 8027284197 |
| Mailing Telephone | 8027284466 |
| Mailing Fax Number | 8027284197 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2019-06-18 |
| Authorized Official Name | MELANIE GIDNEY (DIR. QUALITY ASSURANCE) |
| Authorized Official Telephone | 8027284466 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers | ||
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
Ambulatory Health Care Facilities | ||
| N | 261QP0905X |
Clinic/Center Specialization: Public Health, State or Local |
Ambulatory Health Care Facilities | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | MVP | 63909 | 01 |
| VT | 1009814 | 05 | |
| VT | ANTHEM | 50Y083800VT01 | 01 |
| VT | MVP | 63909C | 01 |
| VT | MVP | 93909A | 01 |
| VT | TRICARE | T000381 | 01 |
| VT | 1007256 | 05 | |
| VT | MVP | 93909 | 01 |
| VT | 1009815 | 05 | |
| VT | BLUE CROSS | VT6178 | 01 |
| VT | 00006178 | 05 | |
| VT | BLUE CROSS | 00800321 | 01 |
| VT | 1006421 | 05 | |
| VT | CIGNA | 1027774 | 01 |
| VT | MVP | 63909A | 01 |
| VT | MVP | 93909C | 01 |
| VT | 1003145 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053679266 | Clara Martin Center | Community/Behavioral Health | 11 Main Street, Randolph, VT 05060 | 2012-04-25 |
| 1902944846 | Clara Martin Center | Clinic/Center | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-02 |
| 1265570113 | Clara Martin Center | Clinic/Center | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-02 |
| 1356489207 | Clara Martin Center | Clinic/Center | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-02 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | CLARA MARTIN CENTER, INC. | 11 Main Street, Randolph, VT 05060 |
| Street Address |
11 S MAIN ST |
| City | RANDOLPH |
| State | VT |
| Zip Code | 05060-1330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982896445 | Elizabeth Macaulay | Counselor | 11 S Main St, P.o. Box G, Randolph, VT 05060-1126 | 2007-08-17 |
| 1255544821 | Annie Luke | Counselor | 11 S Main St, Randolph, VT 05060-1330 | 2007-05-08 |
| 1225150568 | Alida Shriber | Social Worker | 11 S Main St, Randolph, VT 05060-1330 | 2007-04-06 |
| 1073648895 | Shana Kotelchuck | Social Worker | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-22 |
| 1114062213 | Kerrie Taylor | Counselor | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-20 |
| 1831239680 | Linda Chambers | Counselor | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-08 |
| 1902944846 | Clara Martin Center | Clinic/Center | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-02 |
| 1265570113 | Clara Martin Center | Clinic/Center | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-02 |
| 1356489207 | Clara Martin Center | Clinic/Center | 11 S Main St, Randolph, VT 05060-1330 | 2007-02-02 |
| 1437201423 | Tammy Austin | Marriage & Family Therapist | 11 S Main St, Randolph, VT 05060-1330 | 2007-01-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497003099 | Courtney Austin | Pharmacist | 12 North Main St., Randolph, VT 05060 | 2012-08-29 |
| 1851467658 | John Leonard Westbrook | Dentist | 1422 Vt Rt 66, Randolph, VT 05060 | 2006-11-27 |
| 1750470829 | Christopher Mclean Wilson | Dentist | 55 Central Street, Randolph, VT 05060 | 2006-10-12 |
| 1538170006 | Eric C Medved | Physical Therapist | 44 South Main Street, Randolph, VT 05060 | 2006-08-10 |
| 1295100048 | Ashley Shepard | Counselor | 11 N Main St, Randolph, VT 05060 | 2015-12-04 |
| 1326434713 | Emilija O Florance | Family Medicine | 44 S Main St, Randolph, VT 05060 | 2015-04-13 |
| 1891117545 | Penny Fossman | Registered Nurse | 44 S Main St, Randolph, VT 05060 | 2014-01-15 |
| 1053679266 | Clara Martin Center | Community/Behavioral Health | 11 Main Street, Randolph, VT 05060 | 2012-04-25 |
| 1770840829 | Andrea L. Larosa | Nurse Practitioner | 44 South Main Street, Box 2000, Randolph, VT 05060 | 2012-04-13 |
| 1043498561 | Jessica Schupp | Counselor | 11 Main Street, Randolph, VT 05060 | 2008-02-06 |
| Find all providers in zip 05060 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093275638 | David Timpanaro | Community/Behavioral Health | 450 Quaker Church Rd, Randolph, NJ 07869-1373 | 2019-03-20 |
| 1780935676 | Wislinef | Community/Behavioral Health | 3 Dennis Ave, Randolph, MA 02368-1707 | 2012-10-02 |
| 1699031211 | Blessinggrouphome | Community/Behavioral Health | 9 Bossi Ave, Randolph, MA 02368-2001 | 2012-04-09 |
| 1053688507 | Excel Treatment Center | Community/Behavioral Health | 477 State Route 10 Ste 206, Randolph, NJ 07869-2147 | 2011-11-29 |
| 1811210594 | Lamour By Design, Inc | Community/Behavioral Health | 44 Diauto Dr, Randolph, MA 02368-4536 | 2010-03-09 |
| 1295804441 | North Jersey Counseling Centers for Mental and Spiritual Health | Community/Behavioral Health | 891 State Route 10, Randolph, NJ 07869-1906 | 2006-11-06 |
| 1104486539 | Step Up Family Services LLC | Community/Behavioral Health | 450 Quaker Church Rd, Randolph, NJ 07869-1373 | 2019-06-18 |
| 1861940611 | Randolph Behavioral Health D&m | Community/Behavioral Health | 500 N Main St, Randolph, MA 02368-6700 | 2016-09-21 |
| 1891112058 | May Institute | Community/Behavioral Health | 14 Pacella Park Dr, Randolph, MA 02368-1756 | 2014-03-26 |
| 1063839702 | May Institute | Community/Behavioral Health | 14 Pacella Park Dr, Randolph, MA 02368-1756 | 2014-03-19 |
| Find all providers in RANDOLPH | ||||
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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.