Healthcare Provider Details

I. General information

NPI: 1750355368
Provider Name (Legal Business Name): VERMONT CHILDREN'S AID SOCIETY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 WEAVER ST
WINOOSKI VT
05404-2038
US

IV. Provider business mailing address

79 WEAVER ST P.O. BOX 127
WINOOSKI VT
05404-2038
US

V. Phone/Fax

Practice location:
  • Phone: 802-655-0006
  • Fax: 802-457-3086
Mailing address:
  • Phone: 802-655-0006
  • Fax: 802-457-3086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. STEVEN HABIF
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 802-655-0006