Organization
VERICARE OF PENNSYLVANIA, P.C.
Active
Other names
Vericare
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA KING (DIRECTOR, CREDENTIALING ENROLLMENT)
(800) 370-3651
Entity
Organization
Contact information
Practice address
700 FOULK RD, WILMINGTON, DE 19803-3708
(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
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000845019
—
DE
01
—
CC9822
RAILROAD MEDICARE
DE
Enumeration date
05/23/2006
Last updated
07/10/2017
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