Provider Demographics
NPI:1992252357
Name:SCARLETT, WILLIAM IV (LCMHC)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:SCARLETT
Suffix:IV
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 214
Mailing Address - Street 2:
Mailing Address - City:PUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05346-0214
Mailing Address - Country:US
Mailing Address - Phone:802-376-6317
Mailing Address - Fax:
Practice Address - Street 1:133 MAIN ST
Practice Address - Street 2:
Practice Address - City:PUTNEY
Practice Address - State:VT
Practice Address - Zip Code:05346-9226
Practice Address - Country:US
Practice Address - Phone:802-376-6317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000179101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health