| Kiersten Parks Licsw Plc | |
|
8 Pearl St Essex Junction VT 05452-3604 | |
| (802) 404-1901 | |
| Not Available |
| Full Name | Kiersten Parks Licsw Plc |
|---|---|
| Speciality | Social Worker |
| Location | 8 Pearl St, Essex Junction, Vermont |
| Authorized Official Name and Position | Kiersten Parks (OWNER) |
| Authorized Official Contact | 8023987070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kiersten Parks Licsw Plc 24 Cherokee Ave Essex Junction VT 05452-3556 Ph: () - | Kiersten Parks Licsw Plc 8 Pearl St Essex Junction VT 05452-3604 Ph: (802) 404-1901 |
| NPI Number | 1760160105 |
|---|---|
| Provider Enumeration Date | 07/06/2023 |
| Last Update Date | 10/05/2023 |
| Certification Date | 10/05/2023 |
| Medicare PECOS PAC ID | 6709234461 |
|---|---|
| Medicare Enrollment ID | O20231120001053 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760160105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kiersten Elizabeth Parks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225653884 PECOS PAC ID: 7810309903 Enrollment ID: I20201214002958 |
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