Provider Demographics
NPI:1114479730
Name:MEDOPTIONS OF VERMONT LLC
Entity Type:Organization
Organization Name:MEDOPTIONS OF VERMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROJANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-788-6404
Mailing Address - Street 1:PO BOX 1595
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-8095
Mailing Address - Country:US
Mailing Address - Phone:860-788-6404
Mailing Address - Fax:860-829-0495
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4150
Practice Address - Country:US
Practice Address - Phone:860-788-6404
Practice Address - Fax:860-829-0495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT103TC0700X, 1041C0700X, 2084P0800X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty