Healthcare Provider Details
I. General information
NPI: 1144488016
Provider Name (Legal Business Name): SUSAN L SWINDELL LPMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/28/2008
Last Update Date: 12/20/2023
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 HEATON ST
MONTPELIER VT
05602-2489
US
IV. Provider business mailing address
PO BOX 647
MONTPELIER VT
05601-0647
US
V. Phone/Fax
- Phone: 802-223-6328
- Fax: 802-229-8004
- Phone: 802-223-6328
- Fax: 802-229-8004
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 047-0000737 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: