| Gordon Maynard Counseling Services Llc | |
|
343 Upper Depot Rd Marshfield VT 05658-4417 | |
| (208) 660-2943 | |
| Not Available |
| Full Name | Gordon Maynard Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 343 Upper Depot Rd, Marshfield, Vermont |
| Authorized Official Name and Position | Gordon E Maynard (SOLE MEMBER) |
| Authorized Official Contact | 2086602943 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gordon Maynard Counseling Services Llc 343 Upper Depot Rd Marshfield VT 05658-4417 Ph: (208) 660-2943 | Gordon Maynard Counseling Services Llc 343 Upper Depot Rd Marshfield VT 05658-4417 Ph: (208) 660-2943 |
| NPI Number | 1871342568 |
|---|---|
| Provider Enumeration Date | 05/15/2024 |
| Last Update Date | 05/15/2024 |
| Certification Date | 05/15/2024 |
| Medicare PECOS PAC ID | 8729524608 |
|---|---|
| Medicare Enrollment ID | O20240727000101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871342568 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Gordon E Maynard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134202492 PECOS PAC ID: 5193128791 Enrollment ID: I20210720001873 |
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