Provider Demographics
NPI:1780336990
Name:MIKHAILOVA, VERA P (MS, LCMHC)
Entity type:Individual
Prefix:MS
First Name:VERA
Middle Name:P
Last Name:MIKHAILOVA
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:
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Mailing Address - Street 1:225 BROADLAKE RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-6699
Mailing Address - Country:US
Mailing Address - Phone:802-363-9905
Mailing Address - Fax:
Practice Address - Street 1:525 HERCULES DR STE 1A
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-8113
Practice Address - Country:US
Practice Address - Phone:802-391-4806
Practice Address - Fax:802-264-5338
Is Sole Proprietor?:No
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134438101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional