| Green Mountain Behavioral Medicine Llc | |
|
125 Saint Paul St Ste 103 Burlington VT 05401-8686 | |
| (802) 216-0727 | |
| (802) 633-0956 |
| Full Name | Green Mountain Behavioral Medicine Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 125 Saint Paul St Ste 103, Burlington, Vermont |
| Authorized Official Name and Position | Joshua Schupp-star (OWNER/PHYSICIAN ASSISTANT) |
| Authorized Official Contact | 8022301353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Mountain Behavioral Medicine Llc 125 Saint Paul St Ste 103 Burlington VT 05401-8686 Ph: (802) 216-0727 | Green Mountain Behavioral Medicine Llc 125 Saint Paul St Ste 103 Burlington VT 05401-8686 Ph: (802) 216-0727 |
| NPI Number | 1992481568 |
|---|---|
| Provider Enumeration Date | 06/27/2023 |
| Last Update Date | 10/04/2023 |
| Certification Date | 10/04/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992481568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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