Provider Demographics
| NPI: | 1922026996 |
|---|---|
| Name: | WASHINGTON COUNTY MENTAL HEALTH SERVICES, INC. |
| Entity type: | Organization |
| Organization Name: | WASHINGTON COUNTY MENTAL HEALTH SERVICES, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CFO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | HEIDI |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | HALL |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 802-229-1399 |
| Mailing Address - Street 1: | PO BOX 647 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MONTPELIER |
| Mailing Address - State: | VT |
| Mailing Address - Zip Code: | 05601-0647 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 802-229-1399 |
| Mailing Address - Fax: | 802-223-8623 |
| Practice Address - Street 1: | 174 HOSPITAL LOOP |
| Practice Address - Street 2: | |
| Practice Address - City: | BERLIN |
| Practice Address - State: | VT |
| Practice Address - Zip Code: | 05602-9105 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 802-479-4083 |
| Practice Address - Fax: | 802-476-1476 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-07-18 |
| Last Update Date: | 2024-09-23 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
| No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | ||
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health | |
| No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | ||
| No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| VT | 47178 | Other | BLUE CROSS/BLUE SHIELD VT |
| VT | 989026A | Other | MVP - PHD |
| VT | 989026B | Other | MVP - MD/APRN |
| VT | WASH0006053 | Other | BLUE CROSS/BLUE SHIELD VT |
| VT | 989026C | Other | MVP - MASTERS |
| VT | 989026C | Other | MVP - MASTERS |
| VT | 989026B | Other | MVP - MD/APRN |
| VT | 47178 | Other | BLUE CROSS/BLUE SHIELD VT |
| VT | 989026B | Other | MVP - MD/APRN |
