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NPI Code Detail

MEDICARE: VT PSYCHOTHERAPY ASSESSMENT & CONSULTATION SERVICES

MEDICARE: VT PSYCHOTHERAPY ASSESSMENT & CONSULTATION SERVICES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1891485264
Entity Type Code : Organization
Provider Name (Legal Business Name) : VT PSYCHOTHERAPY ASSESSMENT & CONSULTATION SERVICES
Provider Business Mailing Address
First Line : 200 PARK ST
Second Line :
City : MORRISVILLE
State : VT
Zip : 05661-9098
Country : US
Telephone Number : 802-793-8076
Fax Number :
Provider Business Practice Location Address
First Line : 200 PARK ST
Second Line :
City : MORRISVILLE
State : VT
Zip : 05661-9098
Country : US
Telephone Number : 802-793-8076
Fax Number :
Authorized Official
Title or Position : OWNER/PSYCHOLOGIST
Name : ALICIA A WEIN-SENGHAS
Credential : PSYD
Telephone Number : 802-793-8076
Provider Enumeration Date : 05/10/2023
Last Update Date : 05/10/2023

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