OrganizationNetworksSocial WorkerBehavioral Health & Social Service ProvidersPractice Address187 Saint Paul St, Burlington, VT 05401-4689(802) 863-2495PECOS EnrollmentBased on the most recent information from CMS, provider Networks does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1952451650Provider TypeOrganizationFull NameNetworksSubpartNoEnumeration Date1/12/2007Last Updated8/22/2020Contact InformationPractice LocationPractice Address187 Saint Paul St, Burlington, VT 05401-4689Phone(802) 863-2495FaxUnlisted FaxMailing LocationMailing Address187 Saint Paul St, Burlington, VT 05401-4689PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameLovejoy, Andria (Office Manager)Phone(802) 863-2495Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense0890000480VermontProvider IdentifiersIDDescriptionIssuerID1007825DescriptionMedicaidIssuerUnlistedVermont