A Feral Wind Counseling, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

048-0000694 Issued in VT

Legal business name

A FERAL WIND COUNSELING, INC.

Practice address

28 Private Road 8
Middlesex, VT 05602

Phone

(802) 793-9316

Fax

(802) 223-3885

NPI assigned

Jan 23, 2007

Last updated

Aug 22, 2020By 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

Dr. Raven Bruce, PSY.D.NPI 1841419702

Title

President

Phone

(802) 793-9316

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raven Bruce, PSY.D.

  • Clinical Psychologist
  • Middlesex, VT
  • NPI 1841419702
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497809867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 PRIVATE ROAD 8",
            "city": "MIDDLESEX",
            "state": "VT",
            "postal_code": "05602",
            "telephone_number": "802-793-9316",
            "fax_number": "802-223-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 PRIVATE ROAD 8",
            "city": "MIDDLESEX",
            "state": "VT",
            "postal_code": "05602",
            "telephone_number": "802-793-9316",
            "fax_number": "802-223-3885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A FERAL WIND COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "RAVEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "802-793-9316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "68913",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shelby Alberghini
• Stephanie Barclay, BCBA
• Raven Bruce, PSY.D.
• Marge J Dethloff, DC
• Ejd, LLC

• Clinical Psychologist in Middlesex, VT
• Providers in Middlesex, VT by specialty
• Clinical Psychologist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.