| Jessica K. Wright, Lcmhc | |
|
28 Pleasant St Randolph VT 05060-1265 | |
| (802) 505-8596 | |
| Not Available |
| Full Name | Jessica K. Wright, Lcmhc |
|---|---|
| Speciality | Counselor |
| Location | 28 Pleasant St, Randolph, Vermont |
| Authorized Official Name and Position | Jessica K Wright (PROVIDER) |
| Authorized Official Contact | 8025058596 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jessica K. Wright, Lcmhc 3488 Thayer Brook Rd Braintree VT 05060-9201 Ph: (802) 505-8596 | Jessica K. Wright, Lcmhc 28 Pleasant St Randolph VT 05060-1265 Ph: (802) 505-8596 |
| NPI Number | 1265196620 |
|---|---|
| Provider Enumeration Date | 10/22/2021 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Medicare PECOS PAC ID | 7719339415 |
|---|---|
| Medicare Enrollment ID | O20240118001482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265196620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jessica Wright |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629091715 PECOS PAC ID: 3971955683 Enrollment ID: I20240118002011 |
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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 |