Provider Demographics
NPI:1194329078
Name:TOBIN, BRIAN SCOTT (LCMHC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:SCOTT
Last Name:TOBIN
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:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-0584
Mailing Address - Country:US
Mailing Address - Phone:802-249-5896
Mailing Address - Fax:
Practice Address - Street 1:291 BOSTWICK FARM ROAD
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482
Practice Address - Country:US
Practice Address - Phone:802-332-5566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134271101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor