| Doctor Name: | DAVID PELLEGRINO |
| NPI Number: | 1023194925 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCMHC |
| License Number: | 068-0000170 |
| Business Practice Address: | 11 S Main St Randolph, VT - 050601330 |
| Business Phone Number: | 8027284466 |
| Business Fax Number: | 8027284197 |
| Mailing Address: | 20 Forest St, RANDOLPH |
| State: | VT |
| Postal Code: | 050601007 |
| Phone Number: | 8027284407 |
| Fax Number: | |
| NPI Enumeration Date: | 10/31/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 068-0000170 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |