| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1225 Vt-15, Wolcott, Vermont |
| Authorized Official Name and Position | Breanna Hart (PSYCHOTHERAPIST) |
| Authorized Official Contact | 8023085445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1225 Vt-15 Wolcott VT 05680-4560 Ph: (802) 308-5445 | 1225 Vt-15 Wolcott VT 05680 Ph: (802) 760-8191 |
| NPI Number | 1588483523 |
|---|---|
| Provider Enumeration Date | 10/07/2024 |
| Last Update Date | 01/09/2025 |
| Certification Date | 01/06/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588483523 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
15 East Collective Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1225 Vt-15, Wolcott, VT 05680 Phone: 802-323-8392 | |
Serenity Mental Health, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1815 Vt Rte 15, Wolcott, VT 05680 Phone: 802-696-9830 Fax: 802-888-2369 | |
Mary M Fondriest Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1225 Vt-15, Wolcott, VT 05680 Phone: 802-595-9930 |