Provider Demographics
NPI:1497078695
Name:VERMONT CENTER FOR INTEGRATIVE THERAPY, LLC
Entity Type:Organization
Organization Name:VERMONT CENTER FOR INTEGRATIVE THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RUSHFORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MACP
Authorized Official - Phone:802-658-9440
Mailing Address - Street 1:364 DORSET ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6270
Mailing Address - Country:US
Mailing Address - Phone:802-658-9440
Mailing Address - Fax:802-658-9443
Practice Address - Street 1:364 DORSET ST
Practice Address - Street 2:SUITE 204
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-6270
Practice Address - Country:US
Practice Address - Phone:802-658-9440
Practice Address - Fax:802-658-9443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-03
Last Update Date:2012-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty