Provider Demographics
NPI:1750355368
Name:VERMONT CHILDREN'S AID SOCIETY
Entity type:Organization
Organization Name:VERMONT CHILDREN'S AID SOCIETY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HABIF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-655-0006
Mailing Address - Street 1:79 WEAVER ST
Mailing Address - Street 2:P.O. BOX 127
Mailing Address - City:WINOOSKI
Mailing Address - State:VT
Mailing Address - Zip Code:05404-2038
Mailing Address - Country:US
Mailing Address - Phone:802-655-0006
Mailing Address - Fax:802-457-3086
Practice Address - Street 1:79 WEAVER ST
Practice Address - Street 2:
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-2038
Practice Address - Country:US
Practice Address - Phone:802-655-0006
Practice Address - Fax:802-457-3086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1006816Medicaid
VT00006116OtherBLUE CROSS BLUE SHIELD
NH30422436Medicaid
VT=========OtherCBA
VT=========OtherMVP HEALTH PLAN