Provider Demographics
NPI:1427262138
Name:KESLER, MICHAEL WILLIAM (PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:KESLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05773-9800
Mailing Address - Country:US
Mailing Address - Phone:802-446-3577
Mailing Address - Fax:802-446-3801
Practice Address - Street 1:167 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:VT
Practice Address - Zip Code:05773-9800
Practice Address - Country:US
Practice Address - Phone:802-446-3577
Practice Address - Fax:802-446-3801
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014595-1103TC1900X
VT048.0134183103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling