Provider Demographics
NPI:1518331701
Name:HUNTER, NICHOLAS (PSYCHOLOGIST- MASTER)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:PSYCHOLOGIST- MASTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 REYNOLDS DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-3869
Mailing Address - Country:US
Mailing Address - Phone:917-501-2160
Mailing Address - Fax:
Practice Address - Street 1:525 HERCULES DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5993
Practice Address - Country:US
Practice Address - Phone:802-264-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-25
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT047.0093920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical