Provider Demographics
NPI:1326744541
Name:ANODYNE COGNITIVE THERAPY, PLLC
Entity Type:Organization
Organization Name:ANODYNE COGNITIVE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUDHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANTINATH
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-777-6901
Mailing Address - Street 1:20 HIGH GROVE CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1644
Mailing Address - Country:US
Mailing Address - Phone:802-777-6901
Mailing Address - Fax:
Practice Address - Street 1:20 HIGH GROVE CT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1644
Practice Address - Country:US
Practice Address - Phone:802-777-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty