Provider Demographics
NPI:1346339702
Name:STATE OF VERMONT - DEPARTMENT FOR CHILDREN & FAMILIES
Entity Type:Organization
Organization Name:STATE OF VERMONT - DEPARTMENT FOR CHILDREN & FAMILIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAID ACCOUNTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-241-2344
Mailing Address - Street 1:103 S MAIN ST
Mailing Address - Street 2:OSGOOD I
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05671-9800
Mailing Address - Country:US
Mailing Address - Phone:802-241-2252
Mailing Address - Fax:802-241-1106
Practice Address - Street 1:103 S MAIN ST
Practice Address - Street 2:OSGOOD I
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05671-9800
Practice Address - Country:US
Practice Address - Phone:802-241-2252
Practice Address - Fax:802-241-1106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1005104Medicaid
VT1007204Medicaid
VT1004209Medicaid
VT1007032Medicaid
VT1005103Medicaid
VT1008353Medicaid
VT1004694Medicaid
VT1004853Medicaid