| Waxing Crescent Counseling, Llc | |
|
183 Rocky Rdg St Johnsbury VT 05819-8850 | |
| (802) 227-7255 | |
| Not Available |
| Full Name | Waxing Crescent Counseling, Llc |
|---|---|
| Speciality | Counselor |
| Location | 183 Rocky Rdg, St Johnsbury, Vermont |
| Authorized Official Name and Position | Jordan Timmons (CO-OWNER) |
| Authorized Official Contact | 8022277255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waxing Crescent Counseling, Llc 183 Rocky Rdg St Johnsbury VT 05819-8850 Ph: (802) 227-7255 | Waxing Crescent Counseling, Llc 183 Rocky Rdg St Johnsbury VT 05819-8850 Ph: (802) 227-7255 |
| NPI Number | 1205541133 |
|---|---|
| Provider Enumeration Date | 01/16/2023 |
| Last Update Date | 04/16/2024 |
| Certification Date | 01/15/2023 |
| Medicare PECOS PAC ID | 2769907435 |
|---|---|
| Medicare Enrollment ID | O20250416000503 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205541133 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jordan Elizabeth Timmons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821647546 PECOS PAC ID: 7113442880 Enrollment ID: I20250416000627 |
| Provider Name | Kaymo Timmons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275863094 PECOS PAC ID: 4587009956 Enrollment ID: I20250416000758 |
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