Provider Demographics
NPI:1750020574
Name:SELIGSON, NICOLE A (LCMHC)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:SELIGSON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-8309
Mailing Address - Country:US
Mailing Address - Phone:802-922-0690
Mailing Address - Fax:
Practice Address - Street 1:275 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-8309
Practice Address - Country:US
Practice Address - Phone:802-922-0690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680134605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health