Provider Demographics
NPI:1720009731
Name:EHRICH, ELIZABETH COTTER (MSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:COTTER
Last Name:EHRICH
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 1:21 TORY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05250-8978
Mailing Address - Country:US
Mailing Address - Phone:802-282-3302
Mailing Address - Fax:802-375-6110
Practice Address - Street 1:21 TORY LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05250-8978
Practice Address - Country:US
Practice Address - Phone:802-282-3302
Practice Address - Fax:802-375-6110
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0890000615101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT185932000OtherMAGELLAN
VTNE6362OtherEMPIRE BLUE CROSS BLUE SH
VT1006776Medicaid
VT1035699OtherCIGNA
VT25303OtherEMPLOYEE BENEFIT SERVICE
VT29576OtherBLUE CROSS BLUE SHIELD
VT965188OtherMVP
VT185932000OtherMAGELLAN