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FORENSIC CONSULTATION & COUNSELING SERVICE NPI 1083997563


NPI Information

NPI: 1083997563
Provider Name: FORENSIC CONSULTATION & COUNSELING SERVICE

Other Name: FORENSIC CONSULTATION & COUNSELING SERVICE, LLC

Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 47D2244208

Address:
135 GRANGER ST
RUTLAND, VT
ZIP 05701
Phone: (802) 772-0700
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FORENSIC CONSULTATION & COUNSELING SERVICE is an addiction (substance use disorder) counselor in Rutland, VT. FORENSIC CONSULTATION & COUNSELING SERVICE NPI is 1083997563. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Forensic Consultation & Counseling Service, Llc.

The provider's business location address is:

135 GRANGER ST
RUTLAND, VT
ZIP 05701-405
Phone: (802) 772-0700
Fax: (802) 771-8009

The provider's authorized official is Christopher Chadwick .
The authorized official title is Director and has the following contact phone number (802) 772-0700.

The CLIA number assigned to this NPI record is 47D2244208 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/21/2011 and was last updated on 1/6/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1101YM0800XCounselorMental Health068.0047526VERMONTNo
2101YM0800XCounselorMental HealthNo
3101YP2500XCounselorProfessional000447VERMONTNo
41041C0700XSocial WorkerClinicalNo
5363LP2300XNurse PractitionerPrimary CareNo
6101YA0400XCounselorAddiction (Substance Use Disorder)000447VERMONTYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11019731MEDICAIDVERMONT

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: 4/28/2024

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