Provider Demographics
NPI:1821751785
Name:VERDANT WELLNESS, PLLC
Entity Type:Organization
Organization Name:VERDANT WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:802-535-3305
Mailing Address - Street 1:13 MILL ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1514
Mailing Address - Country:US
Mailing Address - Phone:802-535-3305
Mailing Address - Fax:802-535-3305
Practice Address - Street 1:125 SAINT PAUL ST UNIT 104
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8462
Practice Address - Country:US
Practice Address - Phone:802-535-3305
Practice Address - Fax:802-535-3305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty