Provider Demographics
NPI:1558483297
Name:BIRCHWOOD COUNSELING LLC
Entity Type:Organization
Organization Name:BIRCHWOOD COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-851-1030
Mailing Address - Street 1:209 CONGRESS STREET
Mailing Address - Street 2:UNIT 2
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-6065
Mailing Address - Country:US
Mailing Address - Phone:802-851-1030
Mailing Address - Fax:
Practice Address - Street 1:209 CONGRESS ST
Practice Address - Street 2:UNIT 2
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-6065
Practice Address - Country:US
Practice Address - Phone:802-851-1030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTBIRC00069615OtherBLUE CROSS GROUP PIN
VT1012402Medicaid
VT1012402Medicaid