| Village Therapy Resources, Llc | |
|
127 W. 2nd Ste Suite 201 Chadron NE 69337-6933 | |
| (303) 522-1337 | |
| (308) 365-6793 |
| Full Name | Village Therapy Resources, Llc |
|---|---|
| Speciality | Counselor |
| Location | 127 W. 2nd Ste Suite 201, Chadron, Nebraska |
| Authorized Official Name and Position | Jeanice Caporaso (OWNER) |
| Authorized Official Contact | 3035221337 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Therapy Resources, Llc Po Box 926 Chadron NE 69337-0926 Ph: (303) 522-1337 | Village Therapy Resources, Llc 127 W. 2nd Ste Suite 201 Chadron NE 69337-6933 Ph: (303) 522-1337 |
| NPI Number | 1831837012 |
|---|---|
| Provider Enumeration Date | 05/26/2022 |
| Last Update Date | 05/26/2022 |
| Certification Date | 05/10/2022 |
| Medicare PECOS PAC ID | 0446692990 |
|---|---|
| Medicare Enrollment ID | O20240529002438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831837012 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jeanice Gail Caporaso |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568883478 PECOS PAC ID: 1355783804 Enrollment ID: I20240529002520 |
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