Provider Demographics
NPI:1861007650
Name:SOMATIC PSYCHOTHERPY INSTITUTE INC
Entity Type:Organization
Organization Name:SOMATIC PSYCHOTHERPY INSTITUTE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MELIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:802-472-6694
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:
Mailing Address - City:HARDWICK
Mailing Address - State:VT
Mailing Address - Zip Code:05843
Mailing Address - Country:US
Mailing Address - Phone:802-472-6694
Mailing Address - Fax:802-472-6694
Practice Address - Street 1:39 CHURCH ST
Practice Address - Street 2:
Practice Address - City:HARDWICK
Practice Address - State:VT
Practice Address - Zip Code:05843
Practice Address - Country:US
Practice Address - Phone:802-472-6694
Practice Address - Fax:802-472-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-09
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty