Mr Jesse Michael Taylor, LICSW | |
112 Lake St Ste 210, Burlington, VT 05401-5284 | |
(802) 865-3450 | |
Not Available |
Full Name | Mr Jesse Michael Taylor |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 112 Lake St Ste 210, Burlington, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801591045 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 089.0135591 (Vermont) | Primary |
Entity Name | Matrix Health Systems Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1104872712 PECOS PAC ID: 1052219359 Enrollment ID: O20031230000156 |
Mailing Address | Practice Location Address |
---|---|
Mr Jesse Michael Taylor, LICSW 86 Lake St, Burlington, VT 05401-5297 Ph: (802) 865-3450 | Mr Jesse Michael Taylor, LICSW 112 Lake St Ste 210, Burlington, VT 05401-5284 Ph: (802) 865-3450 |
Shannon Kadish, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6600 | |
Elyza Moore, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6000 Fax: 802-488-6919 | |
Ellyn Leamon, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-863-1326 | |
Lauren Carpenter, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 617 Riverside Ave, Burlington, VT 05401 Phone: 802-864-6309 | |
Elaine Soto, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 300 Flynn Ave, Burlington, VT 05401 Phone: 802-488-6300 | |
Jenifer D'aiello, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1 S Prospect St, Burlington, VT 05401 Phone: 802-847-5331 Fax: 802-847-7765 | |
Kathleen Browne, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 617 Riverside Ave, Burlington, VT 05401 Phone: 802-864-6309 Fax: 802-860-4324 |