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General NPI Number Information
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NPI Number | 1225722366
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Entity Type | Individual
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Provider Name | BONNIE CHASE LCMHC
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Gender | Female
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Dates
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Enumeration Date | 06/02/2023
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | ANNA MARSH LANE
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City | BRATTLEBORO
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State | VT
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Zip | 05302
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Country | US
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Telephone | 802-258-4324
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Fax | 802-258-4305
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Provider Business Mailing Address
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Address Line | 15 WOODLAND DR
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City | SPRINGFIELD
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State | VT
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Zip | 05156-2138
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Country | US
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Telephone | 802-289-4730
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Fax | 802-258-4305
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0680084693
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License Number State | VT
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