Provider Demographics
NPI:1740413277
Name:WARNER SOMERS, BOBBI J (MS, LADC, LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:BOBBI
Middle Name:J
Last Name:WARNER SOMERS
Suffix:
Gender:F
Credentials:MS, LADC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2888 US ROUTE 5 S
Mailing Address - Street 2:
Mailing Address - City:BARNET
Mailing Address - State:VT
Mailing Address - Zip Code:05821-9677
Mailing Address - Country:US
Mailing Address - Phone:802-535-8403
Mailing Address - Fax:
Practice Address - Street 1:18 TULIP STREET
Practice Address - Street 2:
Practice Address - City:LYNDONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05851
Practice Address - Country:US
Practice Address - Phone:802-535-8403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-01
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000410101YA0400X
VT0057815101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health