Robert Davis, MED | |
11 N Main St, Randolph, VT 05060-1126 | |
(802) 728-4466 | |
(802) 728-4197 |
Full Name | Robert Davis |
---|---|
Gender | Male |
Speciality | Counselor - Mental Health |
Location | 11 N Main St, Randolph, Vermont |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1154511459 | NPI | - | NPPES |
2393212 | Other | VT | CIGNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | 0680000714 (Vermont) | Primary |
Entity Name | Clara Martin Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386710861 PECOS PAC ID: 1951395367 Enrollment ID: O20060315000608 |
Mailing Address | Practice Location Address |
---|---|
Robert Davis, MED 190 Sugar Plum Ct, Randolph, VT 05060-9379 Ph: (802) 728-6459 | Robert Davis, MED 11 N Main St, Randolph, VT 05060-1126 Ph: (802) 728-4466 |
Renee Weeks, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 | |
David Pellegrino, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 | |
Jessica Schupp, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 Main Street, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 | |
Howard Hood, LCMHC Counselor Medicare: Medicare Enrolled Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 | |
Adam Bindrum, Counselor Medicare: Medicare Enrolled Practice Location: 11 N Main St, Randolph, VT 05060 Phone: 802-728-4466 | |
Kara Rebecca Toms, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 N Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 | |
Kerrie Taylor, LCMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 |