| A Feral Wind Counseling, Inc. | |
|
28 Private Road 8 Middlesex VT 05602 | |
| (802) 793-9316 | |
| (802) 223-3885 |
| Full Name | A Feral Wind Counseling, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 28 Private Road 8, Middlesex, Vermont |
| Authorized Official Name and Position | Raven Bruce (PRESIDENT) |
| Authorized Official Contact | 8027939316 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| A Feral Wind Counseling, Inc. 28 Private Road 8 Middlesex VT 05602 Ph: (802) 793-9316 | A Feral Wind Counseling, Inc. 28 Private Road 8 Middlesex VT 05602 Ph: (802) 793-9316 |
| NPI Number | 1497809867 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4183910276 |
|---|---|
| Medicare Enrollment ID | O20160916000746 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497809867 | NPI | - | NPPES |
| 68913 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 048-0000694 (Vermont) | Primary |
| Provider Name | Raven Bruce |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841419702 PECOS PAC ID: 5890082986 Enrollment ID: I20160916000922 |
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