# GREEN HERON PSYCHOTHERAPY PLLC

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

## Provider details

- **NPI number:** 1194409243
- **Authorized official:** ALLY BERNSTEIN LICSW (MANAGING DIRECTOR)
- **Authorized official phone:** (802) 432-8184

## Contact information

- **Practice address:** 250 HALL CIR, WOODSTOCK, VT 05091-6022
- **Practice address phone:** (802) 432-8184
- **Mailing address:** 250 HALL CIR, WOODSTOCK, VT 05091-6022

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/09/2023
- **Last updated:** 06/09/2023