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NPI Code Detail

MEDICARE: ANDREA ALLI LADC LCMHC

MEDICARE: ANDREA ALLI LADC LCMHC
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
1101YM0800XMental Health Counselor068.0134198VT
2101YA0400XAddiction (Substance Use Disorder) Counselor151-0133423VT

General Provider Information

NPI Number : 1871093104
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA ALLI LADC LCMHC
Provider Business Mailing Address
First Line : 88 SOUTHSHIRE DR
Second Line :
City : BENNINGTON
State : VT
Zip : 05201-9139
Country : US
Telephone Number : 857-284-6654
Fax Number :
Provider Business Practice Location Address
First Line : 5 BANK ST
Second Line :
City : NORTH BENNINGTON
State : VT
Zip : 05257-9102
Country : US
Telephone Number : 802-392-9979
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2018
Last Update Date : 10/25/2022

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Directions to “ ANDREA ALLI LADC LCMHC” Practice Location

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