Provider Demographics
NPI:1932816451
Name:A VERMONT COUNSELING GROUP LLC
Entity Type:Organization
Organization Name:A VERMONT COUNSELING GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:MEZ
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-330-3624
Mailing Address - Street 1:70 S WINOOSKI AVE # 171
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-3898
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:168 BATTERY ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-5285
Practice Address - Country:US
Practice Address - Phone:802-575-1595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty