Provider Demographics
NPI:1407921711
Name:KARABAKAKIS, GEORGE T (PHD)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:T
Last Name:KARABAKAKIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE HOSPITAL COURT
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BELLOW FALLS
Mailing Address - State:VT
Mailing Address - Zip Code:05101
Mailing Address - Country:US
Mailing Address - Phone:802-463-3947
Mailing Address - Fax:802-463-1206
Practice Address - Street 1:ONE HOSPITAL COURT
Practice Address - Street 2:SUITE 410
Practice Address - City:BELLOW FALLS
Practice Address - State:VT
Practice Address - Zip Code:05101
Practice Address - Country:US
Practice Address - Phone:802-463-3294
Practice Address - Fax:802-463-1202
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0480000604103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1010412Medicaid
VT1010412Medicaid