Healthcare Provider Details

I. General information

NPI: 1629450564
Provider Name (Legal Business Name): CENTER FOR ADDICTION RECOGNITION TREATMENT EDUCATION AND RECOVERY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2015
Last Update Date: 06/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 OLD FARM RD
STOWE VT
05672-4434
US

IV. Provider business mailing address

56 OLD FARM RD
STOWE VT
05672-4434
US

V. Phone/Fax

Practice location:
  • Phone: 802-373-2909
  • Fax:
Mailing address:
  • Phone: 802-373-2909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number866
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number16225
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number866
License Number StateVT

VIII. Authorized Official

Name: DR. RICHARD T BARNETT
Title or Position: PRESIDENT/CEO
Credential: PSY.D.
Phone: 802-373-2909