Provider Demographics
NPI:1629280276
Name:BENNINGTON COLLEGE PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:BENNINGTON COLLEGE PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PSYCHOLOGICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:802-440-4450
Mailing Address - Street 1:1 COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-0006
Mailing Address - Country:US
Mailing Address - Phone:802-440-4451
Mailing Address - Fax:802-440-4427
Practice Address - Street 1:1 COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-0006
Practice Address - Country:US
Practice Address - Phone:802-440-4451
Practice Address - Fax:802-440-4427
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0480000888103T00000X
VT0470000653103T00000X
VT04200113182084P0800X
VT04200088952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTBENN00068504OtherBLUE CROSS BLUE SHIELD
CVT405COtherBELLINGER INC
VTBENN00068503OtherBLUE CROSS BLUE SHIELD