| Forensic Consultation & Counseling Service, Llc | |
|
135 Granger St Rutland VT 05701-4405 | |
| (802) 772-0700 | |
| (802) 771-8009 |
| Full Name | Forensic Consultation & Counseling Service, Llc |
|---|---|
| Speciality | Counselor |
| Location | 135 Granger St, Rutland, Vermont |
| Authorized Official Name and Position | Christopher Chadwick (DIRECTOR) |
| Authorized Official Contact | 8027720700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Forensic Consultation & Counseling Service, Llc 135 Granger St Rutland VT 05701-4405 Ph: (802) 772-0700 | Forensic Consultation & Counseling Service, Llc 135 Granger St Rutland VT 05701-4405 Ph: (802) 772-0700 |
| NPI Number | 1083997563 |
|---|---|
| Provider Enumeration Date | 09/21/2011 |
| Last Update Date | 01/06/2022 |
| Certification Date | 12/30/2021 |
| Medicare PECOS PAC ID | 2668865205 |
|---|---|
| Medicare Enrollment ID | O20220203001373 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083997563 | NPI | - | NPPES |
| 1019731 | Medicaid | VT |
| Provider Name | William L Goodwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356770630 PECOS PAC ID: 5395972558 Enrollment ID: I20150109001399 |
| Provider Name | Kristen Marie Sheehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396219580 PECOS PAC ID: 7214262393 Enrollment ID: I20190812003136 |
| Provider Name | Trisha A Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356788319 PECOS PAC ID: 8022015361 Enrollment ID: I20220509000674 |
| Provider Name | Suzanne Mueller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376035097 PECOS PAC ID: 7810348463 Enrollment ID: I20240108004259 |
| Provider Name | Jonathan Chack |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922312347 PECOS PAC ID: 4385095637 Enrollment ID: I20240110004796 |
| Provider Name | Amy Lynn Crowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538872197 PECOS PAC ID: 5991145153 Enrollment ID: I20240504000343 |
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