Provider Demographics
NPI:1104011709
Name:KING, CATHERINE LANG (LCMHC)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LANG
Last Name:KING
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 S PROSPECT ST
Mailing Address - Street 2:SENECA CENTER, ST. JOSEPH BUILDING, 6TH FLOOR
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3456
Mailing Address - Country:US
Mailing Address - Phone:802-847-3333
Mailing Address - Fax:802-847-1424
Practice Address - Street 1:1 S PROSPECT ST
Practice Address - Street 2:SENECA CENTER, ST. JOSEPH BUILDING, 6TH FLOOR
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3456
Practice Address - Country:US
Practice Address - Phone:802-847-3333
Practice Address - Fax:802-847-1424
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000645101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health