| Vermont Wellness Collaborative Inc | |
|
125 Saint Paul St Ste 108 Burlington VT 05401-8686 | |
| (802) 316-8288 | |
| Not Available |
| Full Name | Vermont Wellness Collaborative Inc |
|---|---|
| Speciality | Social Worker |
| Location | 125 Saint Paul St Ste 108, Burlington, Vermont |
| Authorized Official Name and Position | Cyrus Patten (DIRECTOR) |
| Authorized Official Contact | 8023168288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vermont Wellness Collaborative Inc 125 Saint Paul St Ste 108 Burlington VT 05401-8686 Ph: () - | Vermont Wellness Collaborative Inc 125 Saint Paul St Ste 108 Burlington VT 05401-8686 Ph: (802) 316-8288 |
| NPI Number | 1134830409 |
|---|---|
| Provider Enumeration Date | 12/07/2022 |
| Last Update Date | 12/07/2022 |
| Certification Date | 12/07/2022 |
| Medicare PECOS PAC ID | 4486027992 |
|---|---|
| Medicare Enrollment ID | O20230303001333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134830409 | NPI | - | NPPES |
| 6701726 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cyrus Owen Patten |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871962332 PECOS PAC ID: 0143559823 Enrollment ID: I20230303001494 |
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