NPIMap

Organization Active NPI

Forensic Consultation & Counseling Service

  • Addiction (Substance Use Disorder) Counselor
  • Rutland, VT
National Provider Identifier
1083997563
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
000447 Issued in VT
Legal business name
FORENSIC CONSULTATION & COUNSELING SERVICE
Practice address
135 Granger St
Rutland, VT 05701-4405
Phone
(802) 772-0700
Fax
(802) 771-8009
NPI assigned
Sep 21, 2011
Last updated
Jan 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Christopher Chadwick, MS LADC AFCNPI 1255577714
Title
Director
Phone
(802) 772-0700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 000447 VT Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 068.0047526 VT
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 000447 VT
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

135 Granger St
Rutland, VT 05701-4405

Mailing address

135 Granger St
Rutland, VT 05701-4405
Phone (802) 772-0700

Other identifiers 1

IdentifierTypeStateIssuer
1019731MedicaidVT

Other names 2

  • FCCS Other name
  • Forensic Consultation & Counseling Service, LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220203001373 VT Part B Supplier - Clinic/Group Practice 2668865205 Receives reassigned benefits from 6 practitioners
Practice locations: Rutland, VT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
47D2244208Forensic Consultation & Counseling Services135 Granger St, Rutland, VT 05701Certificate of waiverNov 29, 2027

National Provider Directory

National Provider Directory

Locations

135 Granger St
Rutland, VT 05701
Phone (802) 747-3588

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1083997563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GRANGER ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014405",
            "telephone_number": "802-772-0700",
            "fax_number": "802-771-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GRANGER ST",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014405",
            "telephone_number": "802-772-0700",
            "fax_number": "802-771-8009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORENSIC CONSULTATION & COUNSELING SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-21",
        "last_updated": "2022-01-06",
        "certification_date": "2021-12-30",
        "status": "A",
        "authorized_official_last_name": "CHADWICK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "802-772-0700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS LADC AFC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "000447",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0047526",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "VT",
            "license": "000447",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019731",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCCS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Forensic Consultation & Counseling Service, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rutland, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.