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General NPI Number Information
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NPI Number | 1528312980
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH SERVICES OF LAMOILLE VALLEY
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Dates
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Enumeration Date | 11/06/2012
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 65 NORTHGATE PLZ
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City | MORRISVILLE
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State | VT
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Zip | 05661-6099
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Country | US
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Telephone | 802-851-8313
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Fax |
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Provider Business Mailing Address
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Address Line | 218 N MAIN ST
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City | CAMBRIDGE
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State | VT
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Zip | 05444-9810
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Country | US
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Telephone | 802-734-5807
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | STUART MAY
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Credential |
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Telephone | 802-888-0901
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 097.0073318
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License Number State | VT
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