Provider Demographics
NPI:1720778749
Name:VERMONT COUNSELING & BEHAVIORAL MEDICINE INC.
Entity type:Organization
Organization Name:VERMONT COUNSELING & BEHAVIORAL MEDICINE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:N
Authorized Official - Last Name:HACKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:802-782-6219
Mailing Address - Street 1:14 STEBBINS ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-2480
Mailing Address - Country:US
Mailing Address - Phone:802-347-3712
Mailing Address - Fax:802-582-4673
Practice Address - Street 1:14 STEBBINS ST
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-2462
Practice Address - Country:US
Practice Address - Phone:802-347-3712
Practice Address - Fax:802-582-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty