Provider Demographics
NPI:1902837842
Name:STORMES, LOUISE (LCMHC)
Entity Type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:
Last Name:STORMES
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:MRS
Other - First Name:LOUISE
Other - Middle Name:STORMES
Other - Last Name:MANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MILL ST
Mailing Address - Street 2:SUITE 312
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-1530
Mailing Address - Country:US
Mailing Address - Phone:802-863-9775
Mailing Address - Fax:802-863-9779
Practice Address - Street 1:1 MILL ST
Practice Address - Street 2:SUITE 312
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1530
Practice Address - Country:US
Practice Address - Phone:802-863-9775
Practice Address - Fax:802-863-9779
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0000613101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009705Medicaid