Counseling Service of Addison County

Organization Active NPI Substance Use Disorder Rehabilitation Clinic/Center · Middlebury, VT

NPI 1376672402 · NPPES record last updated Oct 18, 2011

Key facts

NPI
1376672402
Entity type
Organization (NPI type 2)
Primary specialty
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Legal business name
COUNSELING SERVICE OF ADDISON COUNTY
Practice address
89 Main St
Middlebury, VT 05753-1459
Phone
(802) 388-6751
Fax
(802) 388-8183
NPI assigned
Mar 5, 2007
Organization subpart
No

Authorized official

Name
Dr. Robert Jimerson, M.D.
Title
Medical Director
Phone
(802) 388-6751

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Counseling Service of Addison County Inc (7 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Yes

Addresses

Primary practice location

89 Main St
Middlebury, VT 05753-1459

Mailing address

89 Main St
Middlebury, VT 05753-1459
Phone (802) 388-6751

Other identifiers

IdentifierTypeStateIssuer
6060011MedicaidVT

Other providers in Middlebury, VT

All providers in Middlebury, VT · Substance Use Disorder Rehabilitation Clinic/Center in Vermont

Sources for this page

Verify at the official NPI Registry.