Provider Demographics
NPI:1255357505
Name:SEIVWRIGHT, JAMES A (MA)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:SEIVWRIGHT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 WESTWARD DR
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-7203
Mailing Address - Country:US
Mailing Address - Phone:802-878-7280
Mailing Address - Fax:
Practice Address - Street 1:245 S PARK DR STE 2
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-5935
Practice Address - Country:US
Practice Address - Phone:802-264-5333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680000246101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006794Medicaid