Phoenix Psychotherapy Llc - Medicare Mental Health Clinic in South Burlington, VT

Phoenix Psychotherapy Llc is a medicare enrolled mental health clinic (Psychologist) in South Burlington, Vermont. The current practice location for Phoenix Psychotherapy Llc is 595 Dorset St Ste 2, South Burlington, Vermont. For appointments, you can reach them via phone at (802) 651-8999. The mailing address for Phoenix Psychotherapy Llc is Po Box 125, Vergennes, Vermont and phone number is (802) 651-8999.

Phoenix Psychotherapy Llc is licensed to practice in Colorado (license number 2051). The clinic also participates in the medicare program and its NPI number is 1114348166. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (802) 651-8999.

Contact Information

Phoenix Psychotherapy Llc
595 Dorset St Ste 2
South Burlington
VT 05403-6240
(802) 651-8999
(802) 651-8997

Mental Health Clinic Profile

Full NamePhoenix Psychotherapy Llc
SpecialityPsychologist
Location595 Dorset St Ste 2, South Burlington, Vermont
Authorized Official Name and PositionJudith Vanderryn (OWNER/SOLE PROPRIETOR)
Authorized Official Contact8026518999
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Phoenix Psychotherapy Llc
Po Box 125
Vergennes
VT 05491-0125

Ph: (802) 651-8999
Phoenix Psychotherapy Llc
595 Dorset St Ste 2
South Burlington
VT 05403-6240

Ph: (802) 651-8999

NPI Details:

NPI Number1114348166
Provider Enumeration Date12/18/2013
Last Update Date12/18/2023
Certification Date12/18/2023

Medicare PECOS Information:

Medicare PECOS PAC ID5597996488
Medicare Enrollment IDO20240118001436

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Medical Identifiers

Medical identifiers for Phoenix Psychotherapy Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1114348166NPI-NPPES
1760587323OtherCOINDIVIDUAL NPI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 2051 (Colorado)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Phoenix Psychotherapy Llc acts as a billing entity for following providers:
Provider NameJudith Henriette Vanderryn
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1760587323
PECOS PAC ID: 7618032988
Enrollment ID: I20240118001798

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› Verified 1 days ago

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