Healthcare Provider Details

I. General information

NPI: 1750775581
Provider Name (Legal Business Name): COURTNEY MARCHETTI, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 MAIN ST SUITE 703
BRATTLEBORO VT
05301-3040
US

IV. Provider business mailing address

PO BOX 910
GREENFIELD MA
01302-0910
US

V. Phone/Fax

Practice location:
  • Phone: 802-246-0035
  • Fax: 802-246-1003
Mailing address:
  • Phone: 800-655-3603
  • Fax: 413-772-8900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY P MARCHETTI
Title or Position: CEO
Credential: MSA
Phone: 774-696-4110