Healthcare Provider Details

I. General information

NPI: 1134116759
Provider Name (Legal Business Name): WASHINGTON COUNTY MENTAL HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 HOSPITAL LOOP
BERLIN VT
05602
US

IV. Provider business mailing address

PO BOX 647
MONTPELIER VT
05601-0647
US

V. Phone/Fax

Practice location:
  • Phone: 802-229-0591
  • Fax: 802-223-8623
Mailing address:
  • Phone: 802-229-0591
  • Fax: 802-223-8623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL DUPRE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 802-229-1399