Provider Demographics
NPI:1376985317
Name:BATTLES, KATHRYN TIPTON (MPS, LADC, LCMHC)
Entity Type:Individual
Prefix:MISS
First Name:KATHRYN
Middle Name:TIPTON
Last Name:BATTLES
Suffix:
Gender:F
Credentials:MPS, LADC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-1526
Mailing Address - Country:US
Mailing Address - Phone:802-782-8110
Mailing Address - Fax:
Practice Address - Street 1:431 PINE ST STE 201
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4726
Practice Address - Country:US
Practice Address - Phone:802-752-6269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000549101YA0400X
VT068.0073059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)