ALEXANDER LODGE MA
NPI 1720700404
Psychologist in Williston, VT

Active since September 19, 2022PECOS EnrolledAccepts Medicare Assignment
75 TALCOTT RD STE 30, WILLISTON, VT 05495(802) 503-2929 Get Directions Write a Review

NPPES record last updated: January 29, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alexander Lodge Ma NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDER LODGE MA (NPI 1720700404) is an individual psychologist in Williston, Vermont, licensed in Vermont (047.0133699) and active in the NPI registry since September 2022. He is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1720700404
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameALEXANDER LODGECredential: MA
Location Address75 TALCOTT RD STE 30Williston, VT 05495-8122
Mailing Address629 Metcalf DrWilliston, VT 05495-8802 · (802) 503-2929
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateSeptember 19, 2022
Last NPPES UpdateJanuary 29, 2024
NPPES CertifiedJanuary 29, 2024
NPI 1720700404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in VT · 047.0133699
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X · License 047.0133699 (VT)
75 TALCOTT RD STE 30, Williston, VT 05495

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Alexander Lodge Ma is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173066636
PECOS Enrollment IDI20240625002468
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
75 TALCOTT RD STE 30
WILLISTON, VT 05495
Psychologist
75 TALCOTT RD STE 30
WILLISTON, VT 05495
Counselor (Mental Health)
75 TALCOTT RD STE 30
WILLISTON, VT 05495
Psychologist
75 TALCOTT RD STE 30
WILLISTON, VT 05495

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alexander Lodge's NPI number?

The NPI number for Alexander Lodge is 1720700404. It was assigned to this individual provider in the NPPES registry on September 19, 2022.

Where is Alexander Lodge located?

Alexander Lodge practices at 75 Talcott Rd Ste 30, Williston, VT 05495. The listed phone number is (802) 503-2929.

What is Alexander Lodge's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Alexander Lodge enrolled in Medicare?

Yes. Alexander Lodge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Alexander Lodge accept?

Health plans from Anthem Blue Cross and Blue Shield list Alexander Lodge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Alexander Lodge was last updated on January 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.