| Vermont Center For Responder Wellness Llc | |
|
162 Hegeman Avenue, Suite 100 Colchester VT 05446 | |
| (802) 377-5137 | |
| Not Available |
| Full Name | Vermont Center For Responder Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 162 Hegeman Avenue, Suite 100, Colchester, Vermont |
| Authorized Official Name and Position | Salvatore J. Provetto (OWNER) |
| Authorized Official Contact | 8023775137 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vermont Center For Responder Wellness Llc 162 Hegeman Avenue, Suite 100 Colchester VT 05446 Ph: (802) 377-5137 | Vermont Center For Responder Wellness Llc 162 Hegeman Avenue, Suite 100 Colchester VT 05446 Ph: (802) 377-5137 |
| NPI Number | 1174154991 |
|---|---|
| Provider Enumeration Date | 01/30/2020 |
| Last Update Date | 12/12/2022 |
| Certification Date | 12/12/2022 |
| Medicare PECOS PAC ID | 0143638379 |
|---|---|
| Medicare Enrollment ID | O20210428000127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174154991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Salvatore Joseph Provetto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386931830 PECOS PAC ID: 3870901002 Enrollment ID: I20210428000163 |
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