Provider Demographics
NPI:1346541836
Name:ALLEN, DAVID D (LADC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:D
Last Name:ALLEN
Suffix:
Gender:M
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MERCHANTS ROW
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-5901
Mailing Address - Country:US
Mailing Address - Phone:802-747-7030
Mailing Address - Fax:
Practice Address - Street 1:51 MERCHANTS ROW
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-5901
Practice Address - Country:US
Practice Address - Phone:802-747-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000226101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)