| Family Tree Counseling Associates, Plc | |
|
250 Main St Ste 101 Montpelier VT 05602-4258 | |
| (802) 223-7364 | |
| (802) 223-8679 |
| Full Name | Family Tree Counseling Associates, Plc |
|---|---|
| Speciality | Social Worker |
| Location | 250 Main St Ste 101, Montpelier, Vermont |
| Authorized Official Name and Position | Kate Vanden Bergh (PART OWNER) |
| Authorized Official Contact | 8022237364 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Tree Counseling Associates, Plc 250 Main St Ste 101 Montpelier VT 05602-4258 Ph: (802) 223-7364 | Family Tree Counseling Associates, Plc 250 Main St Ste 101 Montpelier VT 05602-4258 Ph: (802) 223-7364 |
| NPI Number | 1134271695 |
|---|---|
| Provider Enumeration Date | 01/17/2007 |
| Last Update Date | 11/12/2012 |
| Medicare PECOS PAC ID | 6800048323 |
|---|---|
| Medicare Enrollment ID | O20121210000142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134271695 | NPI | - | NPPES |
| 58392 | Other | VT | BCBS OF VT |
| 1008150 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 089-0000770 (Vermont) | Primary |
| Provider Name | Katherine K Vanden Bergh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558462762 PECOS PAC ID: 2062664592 Enrollment ID: I20121210000162 |
| Provider Name | Jennifer M Calder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134278732 PECOS PAC ID: 4082931654 Enrollment ID: I20150318001944 |
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