| Amanda Wood Licsw Plc | |
|
11 Court Sq Rutland VT 05701-4030 | |
| (802) 884-0377 | |
| (802) 775-5196 |
| Full Name | Amanda Wood Licsw Plc |
|---|---|
| Speciality | Counselor |
| Location | 11 Court Sq, Rutland, Vermont |
| Authorized Official Name and Position | Amanda L Wood (BUSINESS OWNER) |
| Authorized Official Contact | 8026836041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Wood Licsw Plc 11 Court Sq Rutland VT 05701-4030 Ph: (802) 884-0377 | Amanda Wood Licsw Plc 11 Court Sq Rutland VT 05701-4030 Ph: (802) 884-0377 |
| NPI Number | 1518792134 |
|---|---|
| Provider Enumeration Date | 09/04/2024 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 8325572795 |
|---|---|
| Medicare Enrollment ID | O20241107000875 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518792134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Amanda L Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639901507 PECOS PAC ID: 9234663600 Enrollment ID: I20241107001009 |
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