Idlewild Associates, LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

097.0107404 Issued in VT

Legal business name

IDLEWILD ASSOCIATES, LLC

Practice address

153 Main St
Poultney, VT 05764-4413

Phone

(802) 287-0841

NPI assigned

May 14, 2015

Last updated

May 14, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Lisa Ann Citarella, MS

Title

Co-Owner

Phone

(802) 287-0841

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431561600000",
    "number": "1164800884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7",
            "city": "POULTNEY",
            "state": "VT",
            "postal_code": "057640007",
            "telephone_number": "802-287-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 MAIN ST",
            "city": "POULTNEY",
            "state": "VT",
            "postal_code": "057644413",
            "telephone_number": "802-287-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDLEWILD ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-14",
        "last_updated": "2015-05-14",
        "status": "A",
        "authorized_official_last_name": "CITARELLA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "802-287-0841",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "VT",
            "license": "097.0107404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Poultney, VT
• Providers in Poultney, VT by specialty
• Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.