Provider Demographics
NPI:1518157130
Name:HOWE XUEREB, JODY MARTIN (LCMHC)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:MARTIN
Last Name:HOWE XUEREB
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1174
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:VT
Mailing Address - Zip Code:05843-1174
Mailing Address - Country:US
Mailing Address - Phone:802-472-6036
Mailing Address - Fax:802-472-6036
Practice Address - Street 1:20 WAKEFIELD ST.
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:VT
Practice Address - Zip Code:05843
Practice Address - Country:US
Practice Address - Phone:802-472-6036
Practice Address - Fax:802-472-6036
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health