| Alive & Well Llc | |
|
24 Foothills Dr # 11 Jericho VT 05465-2097 | |
| (802) 899-3800 | |
| Not Available |
| Full Name | Alive & Well Llc |
|---|---|
| Speciality | Counselor |
| Location | 24 Foothills Dr # 11, Jericho, Vermont |
| Authorized Official Name and Position | Marcia E Reese (SOLE OWNER) |
| Authorized Official Contact | 8028994662 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alive & Well Llc 24 Foothills Dr # 11 Jericho VT 05465-2097 Ph: (802) 899-3800 | Alive & Well Llc 24 Foothills Dr # 11 Jericho VT 05465-2097 Ph: (802) 899-3800 |
| NPI Number | 1932967346 |
|---|---|
| Provider Enumeration Date | 03/11/2024 |
| Last Update Date | 04/08/2024 |
| Certification Date | 04/08/2024 |
| Medicare PECOS PAC ID | 9234576166 |
|---|---|
| Medicare Enrollment ID | O20240327000798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932967346 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Marcia Ellen Reese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265500482 PECOS PAC ID: 3577908813 Enrollment ID: I20240327000862 |
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