Provider Demographics
NPI:1922089010
Name:HEMLEY, MARCIA W (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARCIA
Middle Name:W
Last Name:HEMLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4525
Mailing Address - Country:US
Mailing Address - Phone:802-863-6114
Mailing Address - Fax:802-951-9950
Practice Address - Street 1:92 ADAMS ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4525
Practice Address - Country:US
Practice Address - Phone:802-863-6114
Practice Address - Fax:802-951-9950
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT480000032103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0002872Medicaid
VTHEVT2872Medicare ID - Type Unspecified