Provider Demographics
NPI:1649779679
Name:SHIRKSHIRE COUNSELING PLC
Entity Type:Organization
Organization Name:SHIRKSHIRE COUNSELING PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:PEPOON
Authorized Official - Suffix:
Authorized Official - Credentials:LADC, LICSW
Authorized Official - Phone:802-733-5566
Mailing Address - Street 1:2092 EAST RD
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05201-8270
Mailing Address - Country:US
Mailing Address - Phone:802-733-5566
Mailing Address - Fax:
Practice Address - Street 1:160 BENMONT AVE STE 31
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-1899
Practice Address - Country:US
Practice Address - Phone:802-733-5566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT151.0124428101YA0400X
VT089.01155461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty