Provider Demographics
NPI:1235363961
Name:SCHOTTLAND, JON (MA)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:SCHOTTLAND
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 1:61 PARKMAN WOOD RD
Mailing Address - Street 2:
Mailing Address - City:PUTNEY
Mailing Address - State:VT
Mailing Address - Zip Code:05346-8993
Mailing Address - Country:US
Mailing Address - Phone:802-387-4827
Mailing Address - Fax:
Practice Address - Street 1:61 PARKMAN WOOD RD
Practice Address - Street 2:
Practice Address - City:PUTNEY
Practice Address - State:VT
Practice Address - Zip Code:05346-8993
Practice Address - Country:US
Practice Address - Phone:802-387-4827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-09
Last Update Date:2009-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097-0000948101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor