NPIMap

Organization Active NPI

Northwestern Counseling & Support Services

  • Community/Behavioral Health Agency
  • Saint Albans, VT
National Provider Identifier
1780708263
Registry record updated Nov 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
NORTHWESTERN COUNSELING & SUPPORT SERVICES
Practice address
107 Fisher Pond Road
Saint Albans, VT 05478-6286
Phone
(802) 524-6554
Fax
(802) 524-6562
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2013

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

Authorized official

Name
Dr. Ted John Mable II, ED.D.
Title
Executive Director
Phone
(802) 524-6555

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X
Community/Behavioral Health Agency 251S00000X Primary
Developmental Disabilities Clinic/Center 261QD1600X

Addresses

Primary practice location

107 Fisher Pond Road
Saint Albans, VT 05478-6286

Mailing address

107 Fisher Pond Road
Saint Albans, VT 05478-6286
Phone (802) 524-6554

Other identifiers 9

IdentifierTypeStateIssuer
6040012MedicaidVT
1006630MedicaidVT
491116OtherVTVALUE OPTIONS
6030001MedicaidVT
CN7031OtherVTRR MEDICARE
2050939OtherVTCIGNA
355023OtherVTMHN
FRAN6103OtherVTBCBS
66316OtherVTMVP

National Provider Directory

National Provider Directory
Tax ID family
Northwestern Counseling Support Services Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384732800000",
    "number": "1780708263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 FISHER POND ROAD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786286",
            "telephone_number": "802-524-6554",
            "fax_number": "802-524-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FISHER POND ROAD",
            "city": "SAINT ALBANS",
            "state": "VT",
            "postal_code": "054786286",
            "telephone_number": "802-524-6554",
            "fax_number": "802-524-6562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWESTERN COUNSELING & SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2013-11-18",
        "status": "A",
        "authorized_official_last_name": "MABLE",
        "authorized_official_first_name": "TED",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "802-524-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "ED.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6040012",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006630",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "491116",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6030001",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CN7031",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2050939",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "355023",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "FRAN6103",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "66316",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Albans, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2013; 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.