William Plath

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Bennington, VT

NPI 1780064014 · NPPES record last updated Jun 28, 2019

Key facts

NPI
1780064014
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
097-0134513 (VT)
Practice address
100 Ledgehill Rd
Bennington, VT 05201
Phone
(802) 442-5491
Fax
(802) 442-3363
NPI assigned
Jun 2, 2015
Sex
Male
Sole proprietor
No

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
097-0134513VTMDAddiction (Substance Use Disorder) Counselor
30794NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 30794 NY
Addiction (Substance Use Disorder) Counselor 101YA0400X 097-0134513 VT Yes

Addresses

Primary practice location

100 Ledgehill Rd
Bennington, VT 05201

Mailing address

100 Ledgehill Rd
Bennington, VT 05201-5200
Phone (802) 442-5491

Other practice location 1

1801 6th Ave
Troy, NY 12180-3440
Phone (518) 274-5143

Other identifiers

IdentifierTypeStateIssuer
01420800MedicaidNY

Other providers in Bennington, VT

All providers in Bennington, VT · Addiction (Substance Use Disorder) Counselor in Vermont

Sources for this page

Verify at the official NPI Registry.