| Village Couseling Associates | |
|
36 Park Pl Suite 101 Brattleboro VT 05301-2802 | |
| (802) 246-1221 | |
| Not Available |
| Full Name | Village Couseling Associates |
|---|---|
| Speciality | Social Worker |
| Location | 36 Park Pl, Brattleboro, Vermont |
| Authorized Official Name and Position | Killy Bascom (OWNER) |
| Authorized Official Contact | 8022461221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Couseling Associates 36 Park Pl Suite 101 Brattleboro VT 05301-2802 Ph: (802) 246-1221 | Village Couseling Associates 36 Park Pl Suite 101 Brattleboro VT 05301-2802 Ph: (802) 246-1221 |
| NPI Number | 1316323223 |
|---|---|
| Provider Enumeration Date | 08/03/2015 |
| Last Update Date | 09/04/2015 |
| Medicare PECOS PAC ID | 1456659812 |
|---|---|
| Medicare Enrollment ID | O20160419000143 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316323223 | NPI | - | NPPES |
| 1021358 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0890087148 (Vermont) | Primary |
| Provider Name | Killy Bascom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366687006 PECOS PAC ID: 0143469171 Enrollment ID: I20130622000093 |
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