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General NPI Number Information
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NPI Number | 1215014725
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Entity Type | Individual
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Provider Name | MATTHEW BIJUR M.S.
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 20 W CANAL ST
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City | WINOOSKI
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State | VT
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Zip | 05404-2131
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Country | US
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Telephone | 802-598-1060
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Fax | 802-425-5435
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Provider Business Mailing Address
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Address Line | 366 FERRY RD
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City | CHARLOTTE
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State | VT
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Zip | 05445-9600
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Country | US
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Telephone | 802-425-5435
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Fax | 802-425-5435
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 000346
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0680000604
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License Number State | VT
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