MEDICARE: MS. ELIZABETH COTTER EHRICH MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	0890000615	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	185932000	OTHER	VT	MAGELLAN
2	NE6362	OTHER	VT	EMPIRE BLUE CROSS BLUE SH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1035699	OTHER	VT	CIGNA
5	25303	OTHER	VT	EMPLOYEE BENEFIT SERVICE
6	29576	OTHER	VT	BLUE CROSS BLUE SHIELD
7	965188	OTHER	VT	MVP

General Provider Information

NPI Number	:	1720009731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH COTTER EHRICH MSW

Provider Business Mailing Address
First Line	:	21 TORY LN
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-8978
Country	:	US
Telephone Number	:	802-282-3302
Fax Number	:	802-375-6110

Provider Business Practice Location Address
First Line	:	21 TORY LN
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-8978
Country	:	US
Telephone Number	:	802-282-3302
Fax Number	:	802-375-6110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	11/01/2013

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