# KILLY BASCOM, LICSW, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Village Couseling Associates
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316323223
- **Authorized official:** KILLY BASCOM LICSW (OWNER)
- **Authorized official phone:** (802) 662-1655

## Contact information

- **Practice address:** 1222 PUTNEY RD, BRATTLEBORO, VT 05301-9000
- **Practice address phone:** (802) 662-1655
- **Mailing address:** PO BOX 8473, BRATTLEBORO, VT 05304-8473
- **Mailing address phone:** (802) 662-1655
- **Mailing address fax:** (802) 662-1655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 0890087148 | VT | Yes |

## Other

- **Enumeration date:** 08/03/2015
- **Last updated:** 09/02/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1021358 | — | VT |