Kiersten Parks Licsw PLC

Organization Active NPI Clinical Social Worker · Essex Junction, VT

NPI 1760160105 · NPPES record last updated Oct 5, 2023

Key facts

NPI
1760160105
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
Legal business name
KIERSTEN PARKS LICSW PLC
Practice address
8 Pearl St
Essex Junction, VT 05452-3604
Phone
(802) 404-1901
NPI assigned
Jul 6, 2023
Organization subpart
No

Authorized official

Name
Kiersten Parks, LICSW
Title
Owner
Phone
(802) 398-7070

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20231120001053 VT Part B Supplier - Clinic/Group Practice 6709234461 Receives reassigned benefits from 1 practitioner
Practice locations: Essex Junction, VT

National Provider Directory

Locations

15 Pinecrest Dr
Essex Junction, VT 05452
Phone (802) 288-1087

37 Lincoln St
Ste 2
Essex Junction, VT 05452
Phone (802) 398-7070

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP
1041C0700X Yes

Addresses

Primary practice location

8 Pearl St
Essex Junction, VT 05452-3604

Mailing address

24 Cherokee Ave
Essex Junction, VT 05452-3556

Other providers in Essex Junction, VT

All providers in Essex Junction, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.