Provider Demographics
NPI:1578687950
Name:EMBERS, JEANA (LCMHC)
Entity Type:Individual
Prefix:
First Name:JEANA
Middle Name:
Last Name:EMBERS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-0504
Mailing Address - Country:US
Mailing Address - Phone:802-295-2600
Mailing Address - Fax:
Practice Address - Street 1:85 N MAIN ST
Practice Address - Street 2:SUITE 210
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-7134
Practice Address - Country:US
Practice Address - Phone:802-295-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT00049353OtherBLUE CROSS BLUE SHIELD
NH30425815Medicaid
VT1007450Medicaid
NH14Y008004VT01OtherANTHEM BCBS
1153402OtherCIGNA