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General NPI Number Information
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NPI Number | 1982742714
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Entity Type | Individual
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Provider Name | MARC D. RICHTER LICSW, LADC, CADC
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 2 CHURCH ST SUITE 3G
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City | BURLINGTON
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State | VT
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Zip | 05401-4299
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Country | US
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Telephone | 866-429-2074
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Fax | 802-540-8199
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Provider Business Mailing Address
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Address Line | 268 CARPENTER RD
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City | CHARLOTTE
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State | VT
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Zip | 05445-9281
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Country | US
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Telephone | 802-425-7771
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Fax | 802-540-8199
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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 | 000372
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License Number State | VT
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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 | 103704
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089-0000658
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License Number State | VT
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