| Brattleboro Retreat | |
|
1 Anna Marsh Lane Brattleboro VT 05302-0803 | |
| (802) 257-7785 | |
| (802) 258-3723 |
| Full Name | Brattleboro Retreat |
|---|---|
| Speciality | Psychiatric Hospital |
| Location | 1 Anna Marsh Lane, Brattleboro, Vermont |
| Authorized Official Name and Position | Doreen Rancourt (CREDENTIALING) |
| Authorized Official Contact | 8022586956 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brattleboro Retreat Po Box 101 Brattleboro VT 05302-0101 Ph: (802) 257-7785 | Brattleboro Retreat 1 Anna Marsh Lane Brattleboro VT 05302-0803 Ph: (802) 257-7785 |
| NPI Number | 1730185232 |
|---|---|
| Provider Enumeration Date | 06/21/2005 |
| Last Update Date | 11/02/2023 |
| Certification Date | 11/02/2023 |
| Medicare PECOS PAC ID | 7012828908 |
|---|---|
| Medicare Enrollment ID | O20041123000627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730185232 | NPI | - | NPPES |
| 0474001 | Medicaid | VT |
| Provider Name | Richard A Marasa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174518708 PECOS PAC ID: 8123922366 Enrollment ID: I20031120000484 |
| Provider Name | Timothy Larosa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063409985 PECOS PAC ID: 3274437033 Enrollment ID: I20031122000103 |
| Provider Name | Geoffrey P Kane |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780671719 PECOS PAC ID: 0446242267 Enrollment ID: I20040401000552 |
| Provider Name | Hannah S Powell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932294261 PECOS PAC ID: 3577545581 Enrollment ID: I20040603000685 |
| Provider Name | Desiree Biesheuvel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629066352 PECOS PAC ID: 2961481510 Enrollment ID: I20040716000524 |
| Provider Name | Thomas R Hoskins |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1275565863 PECOS PAC ID: 7719957315 Enrollment ID: I20040730000104 |
| Provider Name | Sarah K Dudley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265545602 PECOS PAC ID: 2860420262 Enrollment ID: I20050727000866 |
| Provider Name | Magdalena R Naylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184715294 PECOS PAC ID: 8426066150 Enrollment ID: I20060322000498 |
| Provider Name | Heidi Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770687220 PECOS PAC ID: 6002824018 Enrollment ID: I20060403000621 |
| Provider Name | Christine C Gooley |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1225112188 PECOS PAC ID: 3971514928 Enrollment ID: I20060505000534 |
| Provider Name | Marc R Laurens |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477506681 PECOS PAC ID: 8325059090 Enrollment ID: I20060509000540 |
| Provider Name | Kurt L White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023111473 PECOS PAC ID: 4587672142 Enrollment ID: I20060929000369 |
| Provider Name | Jilisa Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962436527 PECOS PAC ID: 3971662909 Enrollment ID: I20081106000037 |
| Provider Name | Elizabeth H Joseph |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1427278456 PECOS PAC ID: 5799836748 Enrollment ID: I20090702000198 |
| Provider Name | Brianna Lu Seaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902074677 PECOS PAC ID: 6709928658 Enrollment ID: I20100115000318 |
| Provider Name | Susanna L Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568482248 PECOS PAC ID: 8426043126 Enrollment ID: I20100303000468 |
| Provider Name | Cory Michael Nohl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184880569 PECOS PAC ID: 9638361082 Enrollment ID: I20101005000037 |
| Provider Name | Jeffrey M Haines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972523660 PECOS PAC ID: 8022093558 Enrollment ID: I20101110000305 |
| Provider Name | Mark Anagnostopulos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326252990 PECOS PAC ID: 0244419869 Enrollment ID: I20110127000640 |
| Provider Name | Lisa A Lambert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215915368 PECOS PAC ID: 9234180142 Enrollment ID: I20110215000285 |
| Provider Name | Marjorie J Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083683239 PECOS PAC ID: 8123013554 Enrollment ID: I20110725000184 |
| Provider Name | Militza Mizray |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902016827 PECOS PAC ID: 7719908045 Enrollment ID: I20110929000072 |
| Provider Name | Jennifer L Fyler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538194089 PECOS PAC ID: 0547432361 Enrollment ID: I20111020000055 |
| Provider Name | Amelia G Shillingford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164711834 PECOS PAC ID: 9032383211 Enrollment ID: I20111128000535 |
| Provider Name | William Knorr |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922095967 PECOS PAC ID: 6305011560 Enrollment ID: I20111216000219 |
| Provider Name | Mark Rj Mcgee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598931156 PECOS PAC ID: 5991963761 Enrollment ID: I20120224000383 |
| Provider Name | Karl Jeffries |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922282938 PECOS PAC ID: 8527235621 Enrollment ID: I20130318000337 |
| Provider Name | Lance B Thigpen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386739209 PECOS PAC ID: 0143210054 Enrollment ID: I20130515000493 |
| Provider Name | Amy Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194754796 PECOS PAC ID: 0042273781 Enrollment ID: I20130821000652 |
| Provider Name | Martha M Coetzee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215914593 PECOS PAC ID: 6608915467 Enrollment ID: I20131118000344 |
| Provider Name | Heather J Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851718241 PECOS PAC ID: 5496979080 Enrollment ID: I20140623001314 |
| Provider Name | Tracey E Krasnow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1740499656 PECOS PAC ID: 1951440767 Enrollment ID: I20140630001647 |
| Provider Name | Simha Ravven |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629210281 PECOS PAC ID: 5799905402 Enrollment ID: I20141001000861 |
| Provider Name | James M Benton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881073187 PECOS PAC ID: 3870807225 Enrollment ID: I20150730010607 |
| Provider Name | John H Fanton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881783397 PECOS PAC ID: 9133196389 Enrollment ID: I20150807014259 |
| Provider Name | Susan F Balaban |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447616834 PECOS PAC ID: 2668777129 Enrollment ID: I20160219002094 |
| Provider Name | Catherine Mattei Williams |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1982791364 PECOS PAC ID: 9830377373 Enrollment ID: I20160516001910 |
| Provider Name | Jerry A Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770850505 PECOS PAC ID: 8527381284 Enrollment ID: I20160614000077 |
| Provider Name | Milangel T Concepcion Zayas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407147564 PECOS PAC ID: 8426344094 Enrollment ID: I20160907002494 |
| Provider Name | Patricia A Dille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730516782 PECOS PAC ID: 4688896574 Enrollment ID: I20160927001155 |
| Provider Name | Marcialee Ledbetter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164492567 PECOS PAC ID: 0840288445 Enrollment ID: I20170103000392 |
| Provider Name | Adnan S Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245363761 PECOS PAC ID: 9032202064 Enrollment ID: I20170106000042 |
| Provider Name | Laura J Kelloway |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861692303 PECOS PAC ID: 3779866405 Enrollment ID: I20170203000864 |
| Provider Name | Judy Katz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376089771 PECOS PAC ID: 3577847698 Enrollment ID: I20170308001903 |
| Provider Name | Johanna Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558809046 PECOS PAC ID: 0446524078 Enrollment ID: I20170921000330 |
| Provider Name | Alan Kyle Hagstrom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619947801 PECOS PAC ID: 5991959207 Enrollment ID: I20171005003580 |
| Provider Name | Mona C Daye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619140316 PECOS PAC ID: 3072640085 Enrollment ID: I20171212000551 |
| Provider Name | Mary F Canale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205279304 PECOS PAC ID: 7618106105 Enrollment ID: I20171213000619 |
| Provider Name | Alvin Fineman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497826051 PECOS PAC ID: 5597753202 Enrollment ID: I20180102001256 |
| Provider Name | Barbara C Pottinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194135335 PECOS PAC ID: 1355561200 Enrollment ID: I20180112000656 |
| Provider Name | Stephanie Ann Cryer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679087977 PECOS PAC ID: 8123387826 Enrollment ID: I20180125000216 |
| Provider Name | Jarred C Zucker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215249560 PECOS PAC ID: 2264792266 Enrollment ID: I20180213001919 |
| Provider Name | Moddy H Kiluvia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922073261 PECOS PAC ID: 4486849411 Enrollment ID: I20180213002381 |
| Provider Name | Lisa Tallin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821506155 PECOS PAC ID: 3173885076 Enrollment ID: I20180312001874 |
| Provider Name | William L Burch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760693691 PECOS PAC ID: 4284700543 Enrollment ID: I20180315000740 |
| Provider Name | Anna May Seaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477842185 PECOS PAC ID: 6800151895 Enrollment ID: I20180522001019 |
| Provider Name | Ergi O Gumusaneli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225283260 PECOS PAC ID: 7315186251 Enrollment ID: I20180718001874 |
| Provider Name | Philip B Laplante |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881099950 PECOS PAC ID: 9537416870 Enrollment ID: I20180718002079 |
| Provider Name | Adam J Pruett |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609050756 PECOS PAC ID: 7315079563 Enrollment ID: I20180813002462 |
| Provider Name | Mark J Cerbone |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497708671 PECOS PAC ID: 3678605292 Enrollment ID: I20180907000256 |
| Provider Name | Susan M Fields |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528247509 PECOS PAC ID: 8123370897 Enrollment ID: I20181008001087 |
| Provider Name | Matthew Dove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124538814 PECOS PAC ID: 3971855545 Enrollment ID: I20181009002459 |
| Provider Name | Amy J Laurent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073670659 PECOS PAC ID: 1951499557 Enrollment ID: I20181010002840 |
| Provider Name | Peter B Kassis |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1962416982 PECOS PAC ID: 1355379835 Enrollment ID: I20181206003106 |
| Provider Name | John E Omalley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811996200 PECOS PAC ID: 6406154491 Enrollment ID: I20181220003056 |
| Provider Name | Sarah J Grosse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225020258 PECOS PAC ID: 1052376258 Enrollment ID: I20190201002499 |
| Provider Name | Christine A Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205859485 PECOS PAC ID: 2567709215 Enrollment ID: I20190204000829 |
| Provider Name | Viorika Nelson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1760422612 PECOS PAC ID: 4082674205 Enrollment ID: I20190212001903 |
| Provider Name | Jason A Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437473998 PECOS PAC ID: 8820120553 Enrollment ID: I20190212002098 |
| Provider Name | Jason M Schmotzer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295771038 PECOS PAC ID: 1759394372 Enrollment ID: I20190221001956 |
| Provider Name | Jaime Stevens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710286489 PECOS PAC ID: 7517271612 Enrollment ID: I20190403000204 |
| Provider Name | Timothy L Kanczuga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295282598 PECOS PAC ID: 0840533568 Enrollment ID: I20190521003002 |
| Provider Name | John-paul Cloutier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205492196 PECOS PAC ID: 9638405434 Enrollment ID: I20190801000624 |
| Provider Name | Luke D Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174939797 PECOS PAC ID: 8628359940 Enrollment ID: I20190822000131 |
| Provider Name | Marissa L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497137277 PECOS PAC ID: 8729316989 Enrollment ID: I20190826002492 |
| Provider Name | Alfred S Goldyne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679817498 PECOS PAC ID: 9739428046 Enrollment ID: I20191017001282 |
| Provider Name | Colin A Polnitsky |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073819819 PECOS PAC ID: 8022441393 Enrollment ID: I20191129000190 |
| Provider Name | Jon Cariker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861915795 PECOS PAC ID: 1951637024 Enrollment ID: I20200115002065 |
| Provider Name | Clarissa Juarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225471154 PECOS PAC ID: 3971743675 Enrollment ID: I20200130001412 |
| Provider Name | Lindsey M Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831741933 PECOS PAC ID: 9133555287 Enrollment ID: I20200207001954 |
| Provider Name | Robin K Caron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1396006698 PECOS PAC ID: 2365740818 Enrollment ID: I20200330000713 |
| Provider Name | Lindsey V Coward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407348675 PECOS PAC ID: 3072855360 Enrollment ID: I20200526002531 |
| Provider Name | Rhonda K Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538286315 PECOS PAC ID: 1951682020 Enrollment ID: I20200604001712 |
| Provider Name | Cindy M Mcdonough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447289533 PECOS PAC ID: 9830126523 Enrollment ID: I20200609001351 |
| Provider Name | Deborah Hoenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508222019 PECOS PAC ID: 6608171632 Enrollment ID: I20200817000300 |
| Provider Name | Julie Tracy-prieboy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356773659 PECOS PAC ID: 8022434463 Enrollment ID: I20200817002366 |
| Provider Name | Kara Dibble |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356904817 PECOS PAC ID: 8729493382 Enrollment ID: I20210213000021 |
| Provider Name | Jessica Shepley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043706419 PECOS PAC ID: 4587068630 Enrollment ID: I20210811002053 |
| Provider Name | Gwynn Yandow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073133831 PECOS PAC ID: 7214332493 Enrollment ID: I20210826000674 |
| Provider Name | Rachael Kandath |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215383732 PECOS PAC ID: 9830432699 Enrollment ID: I20210831002112 |
| Provider Name | Susan M Plante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770681611 PECOS PAC ID: 2264501220 Enrollment ID: I20210902001416 |
| Provider Name | Scott D Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235625294 PECOS PAC ID: 8426307778 Enrollment ID: I20210913000646 |
| Provider Name | Katrina Marie Prive |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679170922 PECOS PAC ID: 0345647418 Enrollment ID: I20210916002849 |
| Provider Name | Nicholas James Hurst |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073855763 PECOS PAC ID: 6406160654 Enrollment ID: I20210930002946 |
| Provider Name | Carly Macken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790300291 PECOS PAC ID: 2062810799 Enrollment ID: I20211012000202 |
| Provider Name | Lydia Greene |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568909851 PECOS PAC ID: 6608265871 Enrollment ID: I20211109000871 |
| Provider Name | Kelcy Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508246695 PECOS PAC ID: 2860795804 Enrollment ID: I20211109002296 |
| Provider Name | Emma Cadman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588327985 PECOS PAC ID: 4587053780 Enrollment ID: I20211109002659 |
| Provider Name | Cynthia J Preis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932151271 PECOS PAC ID: 8325043417 Enrollment ID: I20220310001053 |
| Provider Name | Zachary Wigham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538569918 PECOS PAC ID: 1355726837 Enrollment ID: I20220920001084 |
| Provider Name | Jane M Worley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881682516 PECOS PAC ID: 7618036658 Enrollment ID: I20221209000861 |
| Provider Name | Patricia M Kijak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457073108 PECOS PAC ID: 6507236791 Enrollment ID: I20230104002293 |
| Provider Name | Heather Leonardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366987299 PECOS PAC ID: 9830430446 Enrollment ID: I20230317001054 |
| Provider Name | Heather Barnett Veague |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750631826 PECOS PAC ID: 5991160228 Enrollment ID: I20230420001322 |
| Provider Name | Rachel Owen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669025888 PECOS PAC ID: 1153651153 Enrollment ID: I20230428000862 |
| Provider Name | Adare A Yanagihara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871988238 PECOS PAC ID: 3476897141 Enrollment ID: I20230628001992 |
| Provider Name | Melanie C Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306272687 PECOS PAC ID: 0648405274 Enrollment ID: I20231012000109 |
| Provider Name | Jonathan D Beamer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578511218 PECOS PAC ID: 3678579539 Enrollment ID: I20231012003749 |
| Provider Name | Eliot G Desilva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538121439 PECOS PAC ID: 6901822279 Enrollment ID: I20231113001874 |
| Provider Name | Jessica P Tamulonis |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1386351104 PECOS PAC ID: 9931370152 Enrollment ID: I20231209000750 |
| Provider Name | Chukwuka Sopulu Onubogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568159325 PECOS PAC ID: 4587013834 Enrollment ID: I20231212001104 |
| Provider Name | Nerissa Russo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326449836 PECOS PAC ID: 3870943723 Enrollment ID: I20231219002101 |
| Provider Name | Betty Jane Tullius |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1972616233 PECOS PAC ID: 3476903295 Enrollment ID: I20231220000757 |
| Provider Name | Sarah Catherine Kocz |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356886691 PECOS PAC ID: 8921459132 Enrollment ID: I20240111002317 |
| Provider Name | Katelyn Mulford O'connor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275279457 PECOS PAC ID: 0840641973 Enrollment ID: I20240112001983 |
| Provider Name | Gina Victoria Pearce |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174003354 PECOS PAC ID: 0547612442 Enrollment ID: I20240116003627 |
| Provider Name | Teresa R Butler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699843896 PECOS PAC ID: 8921450743 Enrollment ID: I20240117003252 |
| Provider Name | Darcy E Gingerich |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669435079 PECOS PAC ID: 1658723218 Enrollment ID: I20240118003910 |
| Provider Name | Paul Dilonno |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669692851 PECOS PAC ID: 2466877105 Enrollment ID: I20240119001701 |
| Provider Name | Jenny V Karstad |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831599885 PECOS PAC ID: 7719108950 Enrollment ID: I20240124003077 |
| Provider Name | Steven Prentice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376856286 PECOS PAC ID: 3274775291 Enrollment ID: I20240313001027 |
Innerwell Integrative Counseling Services L3c Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 262 Western Ave, Brattleboro, VT 05301 Phone: 802-231-2550 | |
Moon River Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Homestead Pl, Brattleboro, VT 05301 Phone: 401-489-6463 | |
Springfield Hospital Psychiatry Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 38 Park Pl, Brattleboro, VT 05301 Phone: 802-857-2442 | |
Riggs Neuropsychology Associates, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 Marlboro Rd, Suite 11, Brattleboro, VT 05301 Phone: 802-275-8224 | |
Drift Mavyn Licsw Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 38 Park Pl, Brattleboro, VT 05301 Phone: 802-321-5066 Fax: 802-210-3972 | |
Richard Doucet Licsw Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 36 Park Pl Ste 101, Brattleboro, VT 05301 Phone: 802-246-1221 Fax: 802-246-1002 | |
Crescent Psychotherapy, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 111 High St Apt 4, Brattleboro, VT 05301 Phone: 207-560-6033 |