| Angel Roy Llc | |
|
231 Concord Ave St Johnsbury VT 05819-1515 | |
| (802) 748-5364 | |
| Not Available |
| Full Name | Angel Roy Llc |
|---|---|
| Speciality | Counselor |
| Location | 231 Concord Ave, St Johnsbury, Vermont |
| Authorized Official Name and Position | Angel Roy (OWNER) |
| Authorized Official Contact | 8022491513 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angel Roy Llc 544 Anderson St Barnet VT 05821-9652 Ph: (802) 249-1513 | Angel Roy Llc 231 Concord Ave St Johnsbury VT 05819-1515 Ph: (802) 748-5364 |
| NPI Number | 1588498026 |
|---|---|
| Provider Enumeration Date | 08/28/2024 |
| Last Update Date | 09/06/2024 |
| Certification Date | 09/06/2024 |
| Medicare PECOS PAC ID | 0446781249 |
|---|---|
| Medicare Enrollment ID | O20241003003487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588498026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Angel Roy |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225862766 PECOS PAC ID: 9234660036 Enrollment ID: I20241003003670 |
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