Magnolia Counseling Solutions, PLC
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Bristol, VT
NPI 1013734342 · NPPES record last updated Sep 26, 2024
Key facts
- NPI
- 1013734342
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- MAGNOLIA COUNSELING SOLUTIONS, PLC
- Practice address
- 312 Rockydale Rd
Bristol, VT 05443-5247 - Phone
- (802) 782-2426
- Fax
- (802) 304-5787
- NPI assigned
- Sep 26, 2024
- Organization subpart
- No
Authorized official
- Name
- Ellen Repstad, LICSW
- Title
- Owner
- Phone
- (802) 782-2426
Practitioners 1
-
Ellen Repstad, MSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241017001593 | VT | Part B Supplier - Clinic/Group Practice | 0446782296 |
Receives reassigned benefits from 1 practitioner Practice locations: Bristol, VT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes |
Addresses
Primary practice location
312 Rockydale Rd
Bristol, VT 05443-5247
Mailing address
312 Rockydale Rd
Bristol, VT 05443-5247
Phone (802) 782-2426
Other providers in Bristol, VT
- Sarah Lynn Livingston
- Kelsey Cathcart Lopez
- Hannah Lucarelli
- Paula Lupinetti-Chadwick
- Helen M. Maciejewski
- Shawn R May
- Donna Mergel
- Nancy J Miller
- Molly Milliken
- Megan Morrison
All providers in Bristol, VT · Mental Health Clinic/Center (Including Community Mental Health Center) in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.