Jacquelyn Ellen Bode, MED is a
Psychologist based in Rutland, Vermont. Jacquelyn Ellen Bode is licensed to practice in Vermont (license number 269) and her current practice location is
73 Center St, Rutland, Vermont. She can be reached at her office (for appointments etc.) via phone at
(802) 747-3488.
NPI number for Jacquelyn Ellen Bode is 1780782375 and her current mailing address is 73 Center St, Rutland, Vermont. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1780782375.
Healthcare Provider's Profile
| Full Name | Jacquelyn Ellen Bode |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist |
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| Location | 73 Center St, Rutland, Vermont |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1780782375
- Provider Enumeration Date: 09/20/2006
- Last Update Date: 07/09/2007
Medical Identifiers
Medical identifiers for Jacquelyn Ellen Bode such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780782375 | NPI | - | NPPES |
| 0002611 | Medicaid | VT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 291 (Vermont) | Primary |
| 103T00000X | Psychologist | 269 (Vermont) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacquelyn Ellen Bode is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacquelyn Ellen Bode, MED
73 Center St,
Rutland, VT 05701-4046
Ph: (802) 747-3488 | Jacquelyn Ellen Bode, MED
73 Center St,
Rutland, VT 05701-4046
Ph: (802) 747-3488 |
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