Provider Demographics
NPI:1194093336
Name:CRONIN, CHRISTOPHER WRIGHT (LCMHC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:WRIGHT
Last Name:CRONIN
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 DORSET ST
Mailing Address - Street 2:204
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6270
Mailing Address - Country:US
Mailing Address - Phone:802-777-8537
Mailing Address - Fax:
Practice Address - Street 1:364 DORSET ST
Practice Address - Street 2:204
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6270
Practice Address - Country:US
Practice Address - Phone:802-777-8537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0059485101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health