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NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN NPI 1043343700


NPI Information

NPI: 1043343700
Provider Name: NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN
Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
154 DUCHESS ST
NEWPORT, VT
ZIP 05855
Phone: (802) 334-6744
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NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN is an adolescent and children mental health clinic center in Newport, VT. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. NORTHEAST KINGDOM HUMAN SERVICES INC MH CHILDREN NPI is 1043343700. The provider is registered as an organization entity type.

The provider's business location address is:

154 DUCHESS ST
NEWPORT, VT
ZIP 05855
Phone: (802) 334-6744
Fax: (802) 334-7340

The provider's authorized official is Eric Grims .
The authorized official title is Chief Executive Officer and has the following contact phone number (802) 334-6744.

The enumeration date for this NPI number is 3/13/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11009784MEDICAIDVERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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