Organization
FAMILY TREE COUNSELING ASSOCIATES, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATE VANDEN BERGH LCSW (PART OWNER)
(802) 223-7364
Entity
Organization
Contact information
Practice address
250 MAIN ST STE 101, MONTPELIER, VT 05602-4258
(802) 223-7364
(802) 223-8679
Mailing address
250 MAIN ST STE 101, MONTPELIER, VT 05602-4258
(802) 223-7364
(802) 223-8679
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000770
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008150
—
VT
01
—
58392
BCBS OF VT
VT
Enumeration date
01/17/2007
Last updated
11/12/2012
Update your record
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