Provider Demographics
NPI:1275677338
Name:VERMONT ACADEMY COUNSELING DEPARTMENT
Entity Type:Organization
Organization Name:VERMONT ACADEMY COUNSELING DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-869-6243
Mailing Address - Street 1:20 PLEASANT STREET
Mailing Address - Street 2:
Mailing Address - City:SAXTONS RIVER
Mailing Address - State:VT
Mailing Address - Zip Code:05154
Mailing Address - Country:US
Mailing Address - Phone:802-869-6243
Mailing Address - Fax:
Practice Address - Street 1:20 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:SAXTONS RIVER
Practice Address - State:VT
Practice Address - Zip Code:05154
Practice Address - Country:US
Practice Address - Phone:802-869-6243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101YA0400X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchoolGroup - Multi-Specialty