Provider Demographics
NPI:1265538573
Name:VERMONT CATHOLIC CHARITIES, INC
Entity type:Organization
Organization Name:VERMONT CATHOLIC CHARITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCNAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSWACSW
Authorized Official - Phone:802-658-6111
Mailing Address - Street 1:351 NORTH AVENUE P.O. BOX 489
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05402-0489
Mailing Address - Country:US
Mailing Address - Phone:802-658-6111
Mailing Address - Fax:802-860-0451
Practice Address - Street 1:24 1/2 CENTER ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-4041
Practice Address - Country:US
Practice Address - Phone:802-773-3379
Practice Address - Fax:802-773-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTNA251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1002496Medicaid
VTVN2239Medicare ID - Type UnspecifiedCOUNSELING/FAMILY SERVICE