Alice Glee Haskins

Individual provider Active NPI Mental Health Counselor · Johnson, VT

NPI 1245069764 · NPPES record last updated Aug 1, 2024

Key facts

NPI
1245069764
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
097.0136192 (VT)
Practice address
275 Route 15 W
Johnson, VT 05656-9657
Phone
(802) 635-2805
NPI assigned
Aug 1, 2024
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
097.0136192VTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Laraway Youth & Family Services, Inc. Mental Health Past
since Aug 4, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 097.0136192 VT Yes

Addresses

Primary practice location

275 Route 15 W
Johnson, VT 05656-9657

Mailing address

275 Route 15 W
Johnson, VT 05656-9657
Phone (802) 635-2805

Other providers in Johnson, VT

All providers in Johnson, VT · Mental Health Counselor in Vermont

Sources for this page

Verify at the official NPI Registry.