Provider Demographics
NPI:1336105451
Name:CFC INCORPORATED
Entity Type:Organization
Organization Name:CFC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:802-658-2390
Mailing Address - Street 1:1233 SHELBURNE RD
Mailing Address - Street 2:SUITE D4
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7700
Mailing Address - Country:US
Mailing Address - Phone:802-658-2390
Mailing Address - Fax:
Practice Address - Street 1:1233 SHELBURNE RD
Practice Address - Street 2:SUITE D4
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7700
Practice Address - Country:US
Practice Address - Phone:802-658-2390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000015101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT347880OtherMVP
VT1006850Medicaid
VT5062OtherBCBS