Organization Name: | FORENSIC CONSULTATION & COUNSELING SERVICE, LLC |
NPI Number: | 1083997563 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHRISTOPHER L CHADWICK (DIRECTOR) |
Mailing Address: | 202 N Main St Rutland |
State: | VT US |
Postal Code: | 057012411 |
Phone Number: | 8666399573 |
Fax Number: | 8666399573 |
NPI Enumeration Date: | 09/21/2011 |
NPI Last Update Date: | 09/10/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 000447 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |