Danielle Leriche-Forkey
Individual provider Active NPI Clinical Psychologist · Wolcott, VT
NPI 1629699848 · NPPES record last updated Jun 23, 2020
Key facts
- NPI
- 1629699848
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 047.0133681 (VT)
- Practice address
- 1815 VT Rte 15
Wolcott, VT 05680-3008 - Phone
- (802) 696-9830
- NPI assigned
- Apr 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1815 VT Rte
Suite 15
Wolcott, VT 05680-3008
Phone (802) 696-9830
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201218001190 | VT | Practitioner - Clinical Psychologist | 1951713783 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 047.0133681 | VT | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Mental Health, LLC | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 047.0133681 | VT | Yes |
Addresses
Primary practice location
1815 VT Rte 15
Wolcott, VT 05680-3008
Mailing address
PO Box 1002
Wolcott, VT 05680
Phone (802) 696-9830
Other providers in Wolcott, VT
- Breanna Hart Therapy LLC
- Ann Marie Licari Dryden
- Mary M Fondriest
- Breanna Hart
- Maramonie King
- Mary M Fondriest LLC
- Mya Potts
- Timothy Ricciardello
- Serenity Mental Health, LLC
- Kristen Slade
All providers in Wolcott, VT · Clinical Psychologist in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2020. 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.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.