# NORTHWESTERN COUNSELING & SUPPORT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003623141
- **Authorized official:** KATIE M CYR (BILLING MANAGER)
- **Authorized official phone:** (802) 393-6412

## Contact information

- **Practice address:** 107 FISHER POND RD, SAINT ALBANS, VT 05478-6286
- **Practice address phone:** (802) 524-6554
- **Mailing address:** 107 FISHER POND RD, SAINT ALBANS, VT 05478-6286
- **Mailing address phone:** (802) 524-6554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225XM0800X | Mental Health Occupational Therapist | — | NULL | — |
| 225XM0800X | Mental Health Occupational Therapist | — | — | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/12/2024
- **Last updated:** 12/12/2024