Organization
VERICARE, PC
Active
Organization
VERICARE, PC
Active
Other names
Vericare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT)
(800) 370-3651
Entity
Organization
Contact information
Practice address
11025 VOTH RD, BEAUMONT, TX 77713-8613
(800) 257-8715
(800) 819-1655
Mailing address
55 HATCHETTS HILL RD, OLD LYME, CT 06371-1534
(800) 370-3651
(877) 515-7147
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136136212
—
TX
01
—
CB3582
RAILROAD MEDICARE
TX
Enumeration date
05/05/2006
Last updated
07/11/2017
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