| Jennifer Fellows Licsw, Llc | |
|
1795 Williston Rd Ste 330 South Burlington VT 05403-6487 | |
| (802) 233-7420 | |
| Not Available |
| Full Name | Jennifer Fellows Licsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1795 Williston Rd Ste 330, South Burlington, Vermont |
| Authorized Official Name and Position | Jennifer Fellows (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8022337420 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Fellows Licsw, Llc 291 Pillsbury Ln Williston VT 05495-8728 Ph: (802) 233-7420 | Jennifer Fellows Licsw, Llc 1795 Williston Rd Ste 330 South Burlington VT 05403-6487 Ph: (802) 233-7420 |
| NPI Number | 1467130328 |
|---|---|
| Provider Enumeration Date | 07/10/2023 |
| Last Update Date | 07/10/2023 |
| Certification Date | 07/10/2023 |
| Medicare PECOS PAC ID | 0446613145 |
|---|---|
| Medicare Enrollment ID | O20230829001105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467130328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jennifer Fellows |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225201536 PECOS PAC ID: 4385703354 Enrollment ID: I20230829001264 |
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