Healthcare Provider Details

I. General information

NPI: 1821173998
Provider Name (Legal Business Name): SUSAN STEMBER BUHLMANN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 03/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ANNA MARSH LANE
BRATTLEBORO VT
05302
US

IV. Provider business mailing address

1 ANNA MARSH LANE
BRATTLEBORO VT
05302
US

V. Phone/Fax

Practice location:
  • Phone: 802-258-3700
  • Fax: 802-258-3743
Mailing address:
  • Phone: 802-258-3700
  • Fax: 802-258-3743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05141100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0072501
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: