Organization
CLARA MARTIN CENTER
Active
Organization
CLARA MARTIN CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY A ROSS (CFO)
(802) 728-4466
Entity
Organization
Contact information
Practice address
11 S MAIN ST, RANDOLPH, VT 05060-1330
(802) 728-4466
(802) 728-4197
Mailing address
PO BOX G, RANDOLPH, VT 05060-0167
(802) 728-4466
(802) 728-4197
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00006178
—
VT
01
—
00800321
BLUE CROSS
VT
05
—
1003145
—
VT
05
—
1006421
—
VT
05
—
1007256
—
VT
05
—
1009814
—
VT
05
—
1009815
—
VT
01
—
1027774
CIGNA
VT
01
—
50Y083800VT01
ANTHEM
VT
01
—
63909
MVP
VT
01
—
63909A
MVP
VT
01
—
63909C
MVP
VT
01
—
93909
MVP
VT
01
—
93909A
MVP
VT
01
—
93909C
MVP
VT
01
—
T000381
TRICARE
VT
01
—
VT6178
BLUE CROSS
VT
Enumeration date
11/28/2006
Last updated
09/16/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up