Provider Demographics
NPI:1992132716
Name:ROUNDS, CODY THOMAS (MA)
Entity type:Individual
Prefix:MR
First Name:CODY
Middle Name:THOMAS
Last Name:ROUNDS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 KING ST
Mailing Address - Street 2:SUITE 7
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4880
Mailing Address - Country:US
Mailing Address - Phone:802-363-1055
Mailing Address - Fax:
Practice Address - Street 1:35 KING ST
Practice Address - Street 2:SUITE 7
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4880
Practice Address - Country:US
Practice Address - Phone:802-363-1055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT130.0098062-TRNE103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist