Provider Demographics
NPI:1548430507
Name:CARRUTH, FRANK (MSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:
Last Name:CARRUTH
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1233 SHELBURNE RD STE C5
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7753
Mailing Address - Country:US
Mailing Address - Phone:802-864-4400
Mailing Address - Fax:802-864-4401
Practice Address - Street 1:1233 SHELBURNE RD STE C5
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7753
Practice Address - Country:US
Practice Address - Phone:802-864-4400
Practice Address - Fax:802-864-4401
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00004251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical