Provider Demographics
NPI:1043375249
Name:BROWNSTEIN, SETH (LIC PSYCH-MASTER)
Entity Type:Individual
Prefix:
First Name:SETH
Middle Name:
Last Name:BROWNSTEIN
Suffix:
Gender:M
Credentials:LIC PSYCH-MASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 PINE ST STE 202
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4726
Mailing Address - Country:US
Mailing Address - Phone:802-865-9886
Mailing Address - Fax:
Practice Address - Street 1:431 PINE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4726
Practice Address - Country:US
Practice Address - Phone:802-865-9886
Practice Address - Fax:802-865-3737
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047-0000367103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical