Healthcare Provider Details

I. General information

NPI: 1598813024
Provider Name (Legal Business Name): BRATTLEBORO PASTORAL COUNSELING CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 BELMONT AVE.
BRATTLEBORO VT
05301
US

IV. Provider business mailing address

81 BELMONT AVE
BRATTLEBORO VT
05301
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-9071
  • Fax:
Mailing address:
  • Phone: 802-254-9071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JANET A GOLDSTEIN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 802-254-9071