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General NPI Number Information
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NPI Number | 1164556726
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Entity Type | Organization
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Legal Business Name | SPECTRUM, INC.
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 84 PINE ST FL 2
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City | BURLINGTON
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State | VT
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Zip | 05401-4441
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Country | US
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Telephone | 802-864-7423
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Fax | 833-857-8969
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Provider Business Mailing Address
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Address Line | 31 ELMWOOD AVE
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City | BURLINGTON
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State | VT
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Zip | 05401-4347
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Country | US
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Telephone | 802-864-7423
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Fax | 802-660-0576
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MICHAEL GRANT
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Credential | CPA
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Telephone | 802-864-7423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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