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General NPI Number Information
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NPI Number | 1811387962
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Entity Type | Individual
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Provider Name | ELIZA BEHRSING LICSW
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Gender | Female
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 5399 WILLISTON RD SUITE 207
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City | WILLISTON
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State | VT
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Zip | 05495-5320
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Country | US
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Telephone | 802-489-5826
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Fax | 802-495-5940
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Provider Business Mailing Address
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Address Line | 80 FLETCHER RD
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City | FAIRFAX
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State | VT
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Zip | 05454-9537
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Country | US
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Telephone | 802-497-4913
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089.0085911
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License Number State | VT
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