MEDICARE: MS. LOUISE STORMES 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
1	101YM0800X	Mental Health Counselor	068-0000613	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	:	1902837842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOUISE STORMES LCMHC

Provider Business Mailing Address
First Line	:	1 MILL ST
Second Line	:	SUITE 312
City	:	BURLINGTON
State	:	VT
Zip	:	05401-1530
Country	:	US
Telephone Number	:	802-863-9775
Fax Number	:	802-863-9779

Provider Business Practice Location Address
First Line	:	1 MILL ST
Second Line	:	SUITE 312
City	:	BURLINGTON
State	:	VT
Zip	:	05401-1530
Country	:	US
Telephone Number	:	802-863-9775
Fax Number	:	802-863-9779

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	07/09/2007

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