Provider Demographics
NPI:1821116633
Name:AZIMUTH COUNSELING & THERAPEUTIC SERVICES, INC.
Entity Type:Organization
Organization Name:AZIMUTH COUNSELING & THERAPEUTIC SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILKENS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CASAC
Authorized Official - Phone:802-288-1001
Mailing Address - Street 1:PO BOX 8268
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:VT
Mailing Address - Zip Code:05451-8268
Mailing Address - Country:US
Mailing Address - Phone:802-288-1001
Mailing Address - Fax:802-288-1077
Practice Address - Street 1:8 ESSEX WAY
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3425
Practice Address - Country:US
Practice Address - Phone:802-288-1001
Practice Address - Fax:802-288-1077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty