Jennifer E Pelletier, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

000599 Issued in VT

Practice address

100 Hospitality Drive
Berlin, VT 05602

Phone

(802) 223-4156

Fax

(802) 223-4332

NPI assigned

Aug 13, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gifford Health Care IncGroup PAC ID 2668624982, 37 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gifford Health Care, Inc

  • General Practice Physician
  • Randolph, VT
  • NPI 1013269430
  Medicare reassignment Care Compare group
• Clara Martin Center

  • Community/Behavioral Health Agency
  • Randolph, VT
  • NPI 1548060015
  NPD (past)

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1932532959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX G",
            "city": "RANDOLPH",
            "state": "VT",
            "postal_code": "050600167",
            "telephone_number": "802-728-4466",
            "fax_number": "802-728-4197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITALITY DRIVE",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "05602",
            "telephone_number": "802-223-4156",
            "fax_number": "802-223-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine E Parker, LICSW
• Benjamin P Parkhurst, MD
• Lucy Ann Patti, MD
• Arliene M Pearson, DDS
• Joseph Pekala, MD
• Zoe Renee Perry
• Nicholas Phillips, M.D.
• Erika-Kristina Bradstreet Pineles-Mark, WHNP / CNM
• Elke Pinn, M.D.
• Danielle M. Pinto, BS

• Addiction (Substance Use Disorder) Counselor in Berlin, VT
• Providers in Berlin, VT by specialty
• Addiction (Substance Use Disorder) Counselor in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.