| Lodge Psychotherapy | |
|
75 Talcott Rd Ste 30 Williston VT 05495-8122 | |
| (802) 503-2929 | |
| Not Available |
| Full Name | Lodge Psychotherapy |
|---|---|
| Speciality | Psychologist |
| Location | 75 Talcott Rd Ste 30, Williston, Vermont |
| Authorized Official Name and Position | Alexander Lodge (OWNER) |
| Authorized Official Contact | 8025032929 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lodge Psychotherapy 629 Metcalf Dr Williston VT 05495-8802 Ph: (802) 503-2929 | Lodge Psychotherapy 75 Talcott Rd Ste 30 Williston VT 05495-8122 Ph: (802) 503-2929 |
| NPI Number | 1255053930 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 06/17/2024 |
| Certification Date | 06/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255053930 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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