BRATTLEBORO RETREAT (NPI# 1366002636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366002636 |
| Entity Type | Organization |
| Organization Name | BRATTLEBORO RETREAT |
| Practice Address |
24 Linden Street Brattleboro VT 05302 |
| Practice Telephone | 8022577785 |
| Mailing Telephone | 8022577785 |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |
| Authorized Official Name | CATHY POTTER (SUPERVISOR) |
| Authorized Official Telephone | 8022586885 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1004215 | 05 |
| Other Name | Type Code |
|---|---|
| Linden Street Residential | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730185232 | Brattleboro Retreat | Psychiatric Hospital | Anna Marsh Lane, Brattleboro, VT 05301 | 2005-06-21 |
| 1861749913 | Brattleboro Retreat | Psychiatric Hospital | 1 Anna Marsh Lane, Brattleboro, VT 05301-0101 | 2012-08-08 |
| 1255536991 | Brattleboro Retreat | Psychiatric Hospital | Anna Marsh Lane, Brattleboro, VT 05301 | 2007-06-20 |
| 1164627808 | Brattleboro Retreat | Psychiatric Hospital | Anna Marsh Lane, Brattleboro, VT 05301 | 2007-06-20 |
| 1295947950 | Brattleboro Retreat | Pharmacy | Anna Marsh Lane, Brattleboro, VT 05301 | 2007-05-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Vermont Business Registrations | BRATTLEBORO RETREAT BEAUTY SHOP | 75 Linden Street, Brattleboro, VT 05301 |
| Connecticut Business Registrations | BRATTLEBORO RETREAT CORPORATION | 15 Morgan Farms Drive, S. Windsor, CT 06074 |
| Street Address |
24 LINDEN STREET |
| City | BRATTLEBORO |
| State | VT |
| Zip Code | 05302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205492196 | John-paul Cloutier | Nurse Practitioner | 1 Anna Marsh Ln, Brattleboro, VT 05302 | 2019-05-15 |
| 1659391662 | Donald Kinley | Orthopaedic Surgery | Exit One Park, 71 Gsp Drive, Brattleboro, VT 05302 | 2006-07-20 |
| 1295771038 | Jason M Schmotzer | Psychologist | Brattleboro Retreat, Anna Marsh Lane, Brattleboro, VT 05302 | 2006-06-21 |
| 1437193042 | John Turner Chard | Orthopaedic Surgery | 71 Gsp Dr., Brattleboro, VT 05302 | 2006-06-15 |
| 1174003354 | Gina Victoria Pearce | Counselor | 1 Anna Marsh Lane, Brattleboro, VT 05302 | 2018-08-17 |
| 1821506155 | Lisa M Tallin | Social Worker | 1 Anna Marsh Lane, Brattleboro, VT 05302 | 2018-01-22 |
| 1336654151 | Allison D Nadeau | Counselor | 1 Anna Marsh Lane, Brattleboro, VT 05302 | 2017-12-04 |
| 1649789918 | Emily Worden | Social Worker | 1 Anna Marsh Lane, Tyler4, Brattleboro, VT 05302 | 2017-09-29 |
| 1376089771 | Judy Katz | Social Worker | 1 Anna Marsh Lane, Brattleboro, VT 05302 | 2017-01-10 |
| 1356886691 | Sarah Catherine Kocz | Counselor | Anna Marsh Lane, Brattleboro Retreat Mind Body Pain Management Clinic, Brattleboro, VT 05302 | 2016-12-22 |
| Find all providers in zip 05302 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932303823 | Spruce Mountain Inn, Inc. | Psychiatric Residential Treatment Facility | 155 Towne Ave, Plainfield, VT 05667-0153 | 2007-06-13 |
| 1881816254 | Bromley Brook School | Psychiatric Residential Treatment Facility | 2595 Depot St, Manchester Center, VT 05255-9773 | 2007-05-03 |
| 1962574053 | Uhs of Sutton Inc | Psychiatric Residential Treatment Facility | 2684 King George Farm Rd, Sutton, VT 05867-9626 | 2006-11-14 |
| 1114096278 | Eckerd Youth Alternatives Inc | Psychiatric Residential Treatment Facility | 876 Root Pond Rd, Benson, VT 05743-9596 | 2006-11-06 |
| 1043818677 | Inner Fire, Inc | Psychiatric Residential Treatment Facility | 26 Parker Rd, Brookline, VT 05345-9793 | 2020-10-15 |
| 1356706147 | White River Junction Vamc | Psychiatric Residential Treatment Facility | 215 N Main St, White River Junction, VT 05009-3833 | 2015-12-21 |
| 1073898987 | Merry Meadow Farm | Psychiatric Residential Treatment Facility | 2122 Lower Pln, Bradford, VT 05033-8936 | 2011-10-12 |
| City | BRATTLEBORO |
| Zip Code | 05302 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.