DR. MARK J DETZER (PHD) – Clinical Psychologist, NPI 1215032214
Clinical Psychologist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
169 CLINICAL PSYCHOLOGIST in VT
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Provider Addresses for DR. MARK J DETZER (PHD)
Tip Top Media and Arts Building, 85, North Main Street, White River Junction, Hartford, Windsor County, Vermont, 05001, United States
SUITE 200
WHITE RIVER JUNCTION, VT 050017134
Phone: (802) 299-6498
Fax: (888) 972-1623
Type: Location
PO BOX 712
WHITE RIVER JUNCTION, VT 050010712
Phone: (802) 299-6498
Fax: (888) 972-1623
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-08-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220816003260 | I | Clinical Psychologist | VT | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 90834 | Psychotherapy, 45 minutes | 39 | 11 | $0 |
| 90832 | Psychotherapy, 30 minutes | 18 | 11 | $0 |
Insurance plans in this area (ZIP 05001)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | VT | |
| Physician Assistant | VT | |
| Nurse Practitioner | VT | |
| Physician Assistant | VT | |
| Certified Nurse Midwife (Cnm) | ME | |
| Nurse Practitioner | VT | |
| O T O L A R Y N G O L O G Y | NH | |
| Physical Therapist In Private Practice | VT | |
| - | VT | |
| O B S T E T R I C S/ G Y N E C O L O G Y | NY |
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