DR. MARK J DETZER (NPI# 1215032214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215032214 |
| Entity Type | Individual |
| Full Name | DR. MARK J DETZER |
| Credential | PHD |
| Practice Address |
85 N Main St Suite 200 White River Junction VT 05001-7134 |
| Mailing Address |
Po Box 712 White River Junction VT 05001-0712 |
| Practice Telephone | 8022996498 |
| Practice Fax Number | 8889721623 |
| Mailing Telephone | 8022996498 |
| Mailing Fax Number | 8889721623 |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2013-10-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
854 | NH | Behavioral Health & Social Service Providers |
| Street Address |
85 N MAIN ST SUITE 200 |
| City | WHITE RIVER JUNCTION |
| State | VT |
| Zip Code | 05001-7134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588941090 | William Piatt Ketterer | Psychologist | 85 N Main St, Suite 210, White River Junction, VT 05001-7134 | 2011-11-11 |
| 1578687950 | Jeana Embers | Counselor | 85 N Main St, Suite 210, White River Junction, VT 05001-7134 | 2007-03-19 |
| 1992894810 | Laurie Farr Hanks | Psychologist | 85 N Main St, White River Junction, VT 05001-7134 | 2006-10-11 |
| 1740397405 | David M. Drazin | Psychologist | 85 N Main St, White River Junction, VT 05001-7134 | 2006-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265071674 | Angela Norton | Dietitian, Registered | White River Junction Va, 163 Veterans Drive, White River Junction, VT 05001 | 2020-01-02 |
| 1295221687 | Arielle Courtney Strickland | Behavioral Analyst | 91 Farmvu Dr, White River Junction, VT 05001 | 2018-07-09 |
| 1639544075 | Maureen D Bogosian | Counselor | 211 North Main St, White River, VT 05001 | 2015-12-10 |
| 1104254515 | Peter David Tenenbaum | Social Worker | 67 Raymond Circle, White River Junction, VT 05001 | 2013-10-22 |
| 1124311493 | Amber J Leavitt | Counselor | 226 Holiday Dr Ste 21, White River Junction, VT 05001 | 2011-05-19 |
| 1083820963 | Eileen Frances Lanza | Counselor | 3 Palmer Court, White River Junction, VT 05001 | 2007-05-15 |
| 1841337912 | Carol B. Collier | Counselor | 5 Palmer Court, White River Junction, VT 05001 | 2007-01-30 |
| 1174682041 | Mark G Koch | Marriage & Family Therapist | 1011 N. Main St. #21, White River Junction, VT 05001 | 2006-12-07 |
| 1518032564 | White River Family Practice PC | Family Medicine | 331 Olcott Drive, Suite U3, White River Jct, VT 05001 | 2006-11-22 |
| 1396818100 | Richard Sandford Zubarik | Internal Medicine | Smith 212-fletcher Allen Health Care, Colchester Avenue, Burlington, VT 05001 | 2006-11-17 |
| Find all providers in zip 05001 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801961214 | Mark C Johnson | Psychologist | 2456 Christian Street, Suite 204, White River Junction, VT 05001-1222 | 2006-11-21 |
| 1740391168 | Catherine Jane Kutter | Psychologist | 215 N Main St # 116a0, White River Junction, VT 05009-0001 | 2006-08-31 |
| 1063019529 | Brittany Nicole Norris | Psychologist | 215 N Main St, White River Junction, VT 05009-0001 | 2020-10-07 |
| 1902415334 | Laurie Anne Simontacchi Veillette | Psychologist | 215 N Main St, White River Junction, VT 05009-0001 | 2020-07-31 |
| 1356993612 | Daniel Cheney | Psychologist | 215 N Main St, White River Junction, VT 05009-0001 | 2019-07-16 |
| 1245756394 | Amanda Kutz | Psychologist | 215 Main St, White River Junction, VT 05009 | 2017-08-21 |
| 1346774684 | Casey Allington | Psychologist | 215 N Main St, White River Junction, VT 05009-1000 | 2017-04-13 |
| 1457613572 | Eric Robert Utecht | Psychologist | 215 N Main St, Administrative Desk 60, White River Junction, VT 05009-0001 | 2012-06-14 |
| 1588941090 | William Piatt Ketterer | Psychologist | 85 N Main St, Suite 210, White River Junction, VT 05001-7134 | 2011-11-11 |
| 1811204316 | Erin R Barnett | Psychologist | Veterans Affairs Medical Ctr, 215 North Main St, 116d, White River Junction, VT 05009-0001 | 2010-09-03 |
| Find all providers in WHITE RIVER JUNCTION | ||||
| City | WHITE RIVER JUNCTION |
| Zip Code | 05001 |
Please comment or provide details below to improve the information on DR. MARK J DETZER.
| 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.