Spruce Mountain Inn, Inc.

Primary specialty

Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X

License

0527 Issued in VT

Legal business name

SPRUCE MOUNTAIN INN, INC.

Practice address

155 Towne Ave
Plainfield, VT 05667-0153

Phone

(802) 454-8353

Fax

(802) 454-1008

NPI assigned

Jun 13, 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

Candace Beardsley, LICSW

Title

Director

Phone

(802) 454-8353

Specialties & licenses 1

Addresses

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.

• Sarah Watkins, LICSW

  • Clinical Social Worker
  • Plainfield, VT
  • NPI 1033881438
  NPD (past)

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932303823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 153",
            "address_2": "155 TOWNE AVE",
            "city": "PLAINFIELD",
            "state": "VT",
            "postal_code": "056670153",
            "telephone_number": "802-454-8353",
            "fax_number": "802-454-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 TOWNE AVE",
            "city": "PLAINFIELD",
            "state": "VT",
            "postal_code": "056670153",
            "telephone_number": "802-454-8353",
            "fax_number": "802-454-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRUCE MOUNTAIN INN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEARDSLEY",
        "authorized_official_first_name": "CANDACE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "802-454-8353",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "VT",
            "license": "0527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Retribe Transformations, L3C LLC (ReTribe)
• Robert Stephen Ruhl, DMD
• Barry Robinson Ryan, MD
• Angela Shea, LICSW
• Baylen K Slote, L.AC.
• Malcolm Patrick Van Couvering
• Elizabeth Mae Vanhorn, APRN,FNP-C, RNC-OB
• Cheyanne Elizabeth Warren, D.D.S.
• Janice D Waterman, RD CDE
• Sarah Watkins, LICSW

• Psychiatric Residential Treatment Facility in Plainfield, VT
• Providers in Plainfield, VT by specialty
• Psychiatric Residential Treatment Facility 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.