Provider Demographics
NPI:1912086224
Name:HALL, JOHN BURTON I (LADC, CADC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:BURTON
Last Name:HALL
Suffix:I
Gender:M
Credentials:LADC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:73 MAIN ST
Mailing Address - Street 2:TREATMENT ASSOCIATES SUITE 39
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-2932
Mailing Address - Country:US
Mailing Address - Phone:802-223-6732
Mailing Address - Fax:802-225-1318
Practice Address - Street 1:73 MAIN ST
Practice Address - Street 2:TREATMENT ASSOCIATES SUITE 39
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2932
Practice Address - Country:US
Practice Address - Phone:802-223-6732
Practice Address - Fax:802-225-1318
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000097101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)