NPIMap

Organization Active NPI

Spectrum, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Burlington, VT
National Provider Identifier
1164556726
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
SPECTRUM, INC.
Practice address
84 Pine St FL 2
Burlington, VT 05401-4441
Phone
(802) 864-7423
Fax
(833) 857-8969
NPI assigned
Mar 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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

Authorized official

Name
Michael Grant, CPA
Title
Chief Financial Officer
Phone
(802) 864-7423

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X

Addresses

Primary practice location

84 Pine St FL 2
Burlington, VT 05401-4441

Mailing address

31 Elmwood Ave
Burlington, VT 05401-4347
Phone (802) 864-7423

Other identifiers 3

IdentifierTypeStateIssuer
1006363MedicaidVT
28311OtherVTBLUE CROSS BLUE SHIELD
1016884MedicaidVT

Other names 2

  • Spectrum Youth and Family Services, Inc. Doing business as
  • Spectrum, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

31 Elmwood Ave
Burlington, VT 05401
Phone (802) 836-7423

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1164556726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 ELMWOOD AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014347",
            "telephone_number": "802-864-7423",
            "fax_number": "802-660-0576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 PINE ST FL 2",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014441",
            "telephone_number": "802-864-7423",
            "fax_number": "833-857-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "802-864-7423",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006363",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28311",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016884",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Youth and Family Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spectrum, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.