Individual
MR. CHARLES SCOTT EARISMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
28 PARK AVENUE, SUITE 110, WILLISTON, VT 05495
(802) 878-0550
(802) 878-0440
Mailing address
28 PARK AVENUE, SUITE 110, WILLISTON, VT 05495
(802) 878-0550
(802) 878-0440
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000067
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
068-0000427
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007109
—
VT
Enumeration date
11/10/2006
Last updated
12/16/2010
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