| Phoenix Psychotherapy Llc | |
|
595 Dorset St Ste 2 South Burlington VT 05403-6240 | |
| (802) 651-8999 | |
| (802) 651-8997 |
| Full Name | Phoenix Psychotherapy Llc |
|---|---|
| Speciality | Psychologist |
| Location | 595 Dorset St Ste 2, South Burlington, Vermont |
| Authorized Official Name and Position | Judith Vanderryn (OWNER/SOLE PROPRIETOR) |
| Authorized Official Contact | 8026518999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phoenix Psychotherapy Llc Po Box 125 Vergennes VT 05491-0125 Ph: (802) 651-8999 | Phoenix Psychotherapy Llc 595 Dorset St Ste 2 South Burlington VT 05403-6240 Ph: (802) 651-8999 |
| NPI Number | 1114348166 |
|---|---|
| Provider Enumeration Date | 12/18/2013 |
| Last Update Date | 12/18/2023 |
| Certification Date | 12/18/2023 |
| Medicare PECOS PAC ID | 5597996488 |
|---|---|
| Medicare Enrollment ID | O20240118001436 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114348166 | NPI | - | NPPES |
| 1760587323 | Other | CO | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 2051 (Colorado) | Primary |
| Provider Name | Judith Henriette Vanderryn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760587323 PECOS PAC ID: 7618032988 Enrollment ID: I20240118001798 |
Kristen Johnson Counseling And Consulting, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Link Rd, South Burlington, VT 05403 Phone: 802-598-8168 | |
Finding Ways Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: N4 Stonehedge Dr, South Burlington, VT 05403 Phone: 603-714-0868 | |
Howard Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 San Remo Dr, South Burlington, VT 05403 Phone: 802-488-7350 Fax: 802-488-6919 | |
Zaanti Psychotherapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 34 Patchen Rd, South Burlington, VT 05403 Phone: 802-658-4208 Fax: 802-658-2234 | |
Green Mountain Psychotherapy Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1233 Shelburne Rd Ste 460a, South Burlington, VT 05403 Phone: 802-391-9137 | |
Wind River Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 54 W Twin Oaks Ter Ste 12, South Burlington, VT 05403 Phone: 802-391-9073 |