Provider Demographics
NPI:1306551718
Name:ANNIE LAWSON LICSW LLC
Entity type:Organization
Organization Name:ANNIE LAWSON LICSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EMPLOYER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-343-5169
Mailing Address - Street 1:51 STANIFORD RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05408-2437
Mailing Address - Country:US
Mailing Address - Phone:802-343-5169
Mailing Address - Fax:
Practice Address - Street 1:267 PEARL ST STE 10
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8543
Practice Address - Country:US
Practice Address - Phone:802-343-5169
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty