| Carolyn Edwards Basiliere Llc | |
|
156 College St Ste 201 Burlington VT 05401-8423 | |
| (802) 657-3647 | |
| (802) 860-0183 |
| Full Name | Carolyn Edwards Basiliere Llc |
|---|---|
| Speciality | Psychologist |
| Location | 156 College St Ste 201, Burlington, Vermont |
| Authorized Official Name and Position | Carolyn Edwards Basiliere (PSYCHOLOGIST) |
| Authorized Official Contact | 8026573647 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Carolyn Edwards Basiliere Llc 11 Simpson Ct South Burlington VT 05403-6326 Ph: (802) 657-3647 | Carolyn Edwards Basiliere Llc 156 College St Ste 201 Burlington VT 05401-8423 Ph: (802) 657-3647 |
| NPI Number | 1841969482 |
|---|---|
| Provider Enumeration Date | 09/08/2021 |
| Last Update Date | 09/08/2021 |
| Certification Date | 09/08/2021 |
| Medicare PECOS PAC ID | 0749687325 |
|---|---|
| Medicare Enrollment ID | O20210923003323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841969482 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Carolyn Edwards Basiliere |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447325550 PECOS PAC ID: 2668532201 Enrollment ID: I20081201000423 |
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