| Clara Martin Center | |
|
11 S Main St Randolph VT 05060-1330 | |
| (802) 728-4466 | |
| (802) 728-4197 |
| Full Name | Clara Martin Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 11 S Main St, Randolph, Vermont |
| Authorized Official Name and Position | Melanie Gidney (DIR. QUALITY ASSURANCE) |
| Authorized Official Contact | 8027284466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clara Martin Center Po Box G Randolph VT 05060 Ph: (802) 728-4466 | Clara Martin Center 11 S Main St Randolph VT 05060-1330 Ph: (802) 728-4466 |
| NPI Number | 1386710861 |
|---|---|
| Provider Enumeration Date | 11/28/2006 |
| Last Update Date | 06/18/2019 |
| Medicare PECOS PAC ID | 1951395367 |
|---|---|
| Medicare Enrollment ID | O20060315000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386710861 | NPI | - | NPPES |
| 1003145 | Medicaid | VT | |
| T000381 | Other | VT | TRICARE |
| VT6178 | Other | VT | BLUE CROSS |
| 63909C | Other | VT | MVP |
| 93909A | Other | VT | MVP |
| 93909 | Other | VT | MVP |
| 1007256 | Medicaid | VT | |
| 1009814 | Medicaid | VT | |
| 1027774 | Other | VT | CIGNA |
| 00800321 | Other | VT | BLUE CROSS |
| 1009815 | Medicaid | VT | |
| 63909A | Other | VT | MVP |
| 00006178 | Medicaid | VT | |
| 1006421 | Medicaid | VT | |
| 50Y083800VT01 | Other | VT | ANTHEM |
| 63909 | Other | VT | MVP |
| 93909C | Other | VT | MVP |
| Provider Name | Maria Cabri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255384889 PECOS PAC ID: 2567408172 Enrollment ID: I20091231000338 |
| Provider Name | Alexis Sargent |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134381866 PECOS PAC ID: 8022151893 Enrollment ID: I20100202000168 |
| Provider Name | Kevin L Buchanan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194807040 PECOS PAC ID: 2668643313 Enrollment ID: I20110929000145 |
| Provider Name | Karen D Mcginty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316209109 PECOS PAC ID: 6608025606 Enrollment ID: I20121008000568 |
| Provider Name | Jenni M Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912245143 PECOS PAC ID: 2668618018 Enrollment ID: I20130410000017 |
| Provider Name | Christie Everett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568703536 PECOS PAC ID: 9739326315 Enrollment ID: I20130520000520 |
| Provider Name | Tina Brownley-stevenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730549031 PECOS PAC ID: 0840598108 Enrollment ID: I20160420000178 |
| Provider Name | Craig Smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871655209 PECOS PAC ID: 4486930591 Enrollment ID: I20170404000370 |
| Provider Name | Dawn Palladino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831609494 PECOS PAC ID: 1759657166 Enrollment ID: I20171030000893 |
| Provider Name | Gretchen Van Winkle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093208423 PECOS PAC ID: 9537417357 Enrollment ID: I20180809004897 |
| Provider Name | Sherry L Barnard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073798666 PECOS PAC ID: 3779813795 Enrollment ID: I20190918000371 |
| Provider Name | Carrie H Russell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730363268 PECOS PAC ID: 2769713783 Enrollment ID: I20191007000141 |
| Provider Name | Majida E Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811462492 PECOS PAC ID: 1153658950 Enrollment ID: I20200611002808 |
| Provider Name | Courtney S Ness |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831531078 PECOS PAC ID: 3971908153 Enrollment ID: I20210826000996 |
| Provider Name | Kristen Briggs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649935040 PECOS PAC ID: 7719379106 Enrollment ID: I20220114001143 |
| Provider Name | Brittany Faith Crowley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811382864 PECOS PAC ID: 5799090791 Enrollment ID: I20220913003361 |
| Provider Name | Kathleen E Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417663600 PECOS PAC ID: 8921461468 Enrollment ID: I20230830003538 |
| Provider Name | Crystal Irish |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1972193266 PECOS PAC ID: 5799135331 Enrollment ID: I20231222001877 |
| Provider Name | Kate Lohutko |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902432792 PECOS PAC ID: 9739530700 Enrollment ID: I20240104001286 |
| Provider Name | Alicia Holden |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629522990 PECOS PAC ID: 7113378191 Enrollment ID: I20240104001591 |
| Provider Name | Ashley Shepard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295100048 PECOS PAC ID: 2062863947 Enrollment ID: I20240104001882 |
| Provider Name | Gretchen Pembroke Cate |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790045037 PECOS PAC ID: 6103277900 Enrollment ID: I20240105001575 |
| Provider Name | Karen L Butler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1982929477 PECOS PAC ID: 6709237456 Enrollment ID: I20240108003632 |
| Provider Name | April Ketchum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801363908 PECOS PAC ID: 2062864168 Enrollment ID: I20240113000021 |
| Provider Name | Danielle Ferry |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457828188 PECOS PAC ID: 8022460120 Enrollment ID: I20240113000131 |
| Provider Name | Demetra Hazatones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083907281 PECOS PAC ID: 2466804570 Enrollment ID: I20240113000274 |
| Provider Name | Amanda Plante |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366137853 PECOS PAC ID: 7214389089 Enrollment ID: I20240117001787 |
| Provider Name | Jennifer Beaudin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396482345 PECOS PAC ID: 1557713336 Enrollment ID: I20240117001941 |
| Provider Name | Andrew Nuss |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346476561 PECOS PAC ID: 6507218880 Enrollment ID: I20240123001418 |
| Provider Name | Melanie Williams |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306204961 PECOS PAC ID: 8527410828 Enrollment ID: I20240123001988 |
| Provider Name | Robert Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154511459 PECOS PAC ID: 6800249087 Enrollment ID: I20240124004021 |
| Provider Name | Adam Bindrum |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093045718 PECOS PAC ID: 2769835362 Enrollment ID: I20240131000785 |
| Provider Name | Tanya R Croke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477323939 PECOS PAC ID: 1658716568 Enrollment ID: I20240301001976 |
| Provider Name | Joshua B Amses |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568227171 PECOS PAC ID: 7517306681 Enrollment ID: I20240423000449 |
Clara Martin Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 Main Street, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 | |
Jessica K. Wright, Lcmhc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 28 Pleasant St, Randolph, VT 05060 Phone: 802-505-8596 | |
Marjorie R Crowe Msw Corp Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1 Belle Fred Dr, Randolph, VT 05060 Phone: 802-728-3018 | |
Clara Martin Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11 S Main St, Randolph, VT 05060 Phone: 802-728-4466 Fax: 802-728-4197 |