Provider Demographics
NPI:1700829397
Name:REED, MICHELE MUNSON (MSW)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:MUNSON
Last Name:REED
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-1547
Mailing Address - Country:US
Mailing Address - Phone:802-144-1748
Mailing Address - Fax:
Practice Address - Street 1:93 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1547
Practice Address - Country:US
Practice Address - Phone:802-144-1748
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-0000060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1008813Medicaid
VT61771OtherMVP HEALTH PLAN
VT5089OtherBCBS OF VT.
VT61771OtherMVP HEALTH PLAN