| Billie Fairbrother, Licsw, Llc | |
|
36 Park Pl Suite 101 Brattleboro VT 05301-2802 | |
| (802) 246-1221 | |
| (802) 246-1002 |
| Full Name | Billie Fairbrother, Licsw, Llc |
|---|---|
| Speciality | Counselor |
| Location | 36 Park Pl, Brattleboro, Vermont |
| Authorized Official Name and Position | Billie Jo Fairbrother (THERAPIST) |
| Authorized Official Contact | 8022461221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Billie Fairbrother, Licsw, Llc 36 Park Pl Suite 101 Brattleboro VT 05301-2802 Ph: (802) 246-1221 | Billie Fairbrother, Licsw, Llc 36 Park Pl Suite 101 Brattleboro VT 05301-2802 Ph: (802) 246-1221 |
| NPI Number | 1497141063 |
|---|---|
| Provider Enumeration Date | 04/10/2015 |
| Last Update Date | 04/10/2015 |
| Medicare PECOS PAC ID | 7113246612 |
|---|---|
| Medicare Enrollment ID | O20150505001925 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497141063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0890101573 (Vermont) | Primary |
| Provider Name | Billie Jo Fairbrother |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356742274 PECOS PAC ID: 0648599142 Enrollment ID: I20150505001993 |
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