MEDICARE: KATHERINE KILMURRY RN,LCMHC,LADC,CADC

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	101YM0800X	Mental Health Counselor	068-0000494	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	:	1750460606
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE KILMURRY RN,LCMHC,LADC,CADC

Provider Business Mailing Address
First Line	:	26 FREEDOM DR
Second Line	:
City	:	MONTPELIER
State	:	VT
Zip	:	05602-3357
Country	:	US
Telephone Number	:	802-223-6074
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 MAIN ST
Second Line	:
City	:	MONTPELIER
State	:	VT
Zip	:	05602-2932
Country	:	US
Telephone Number	:	802-223-6732
Fax Number	:	802-225-1318

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

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	07/09/2007

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