Paul Rodrigue

Individual provider Active NPI Marriage & Family Therapist · Brattleboro, VT

NPI 1205939501 · NPPES record last updated Sep 18, 2008

Key facts

NPI
1205939501
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1000-0000027 (VT)
Practice address
Anna Marsh Lane
Brattleboro, VT 05302
Phone
(802) 257-7785
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

167 Main St
Brattleboro, VT 05301-3057
Phone 80225839142

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20240111004217 VT Practitioner - Marriage and Family Therapist 9335590595 Practice locations: Brattleboro, VT

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1000-0000027VTMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1000-0000027 VT Yes

Addresses

Primary practice location

Anna Marsh Lane
Brattleboro, VT 05302

Mailing address

Anna Marsh Lane
Brattleboro, VT 05302
Phone (802) 257-7785

Other identifiers

IdentifierTypeStateIssuer
1007584MedicaidVT
1000-0000027OtherVTLICENSE

Other providers in Brattleboro, VT

All providers in Brattleboro, VT · Marriage & Family Therapist in Vermont

Sources for this page

Verify at the official NPI Registry.