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General NPI Number Information
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NPI Number | 1124819214
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Entity Type | Organization
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Legal Business Name | CONFLUENCE PSYCHOTHERAPY PLC
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 114 CEMETERY AVE
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City | MANCHESTER CENTER
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State | VT
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Zip | 05255-9701
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Country | US
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Telephone | 802-440-0972
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | EAST ARLINGTON
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State | VT
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Zip | 05252-0187
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Country | US
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Telephone | 802-440-0972
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. CHAD ALLEN LAZZARI
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Credential | PSYD
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Telephone | 802-440-0972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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