MEDICARE: VICTORIA E COLVIN LICSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	000049	VT
2	1041C0700X	Clinical Social Worker	089-0000104	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447289541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA E COLVIN LICSW

Provider Business Mailing Address
First Line	:	142 CREEKSIDE DR
Second Line	:
City	:	SHELBURNE
State	:	VT
Zip	:	05482-7567
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	855 PINE ST
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-4924
Country	:	US
Telephone Number	:	802-862-6459
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	09/11/2025

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Directions to “ VICTORIA E COLVIN LICSW” Practice Location

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