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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
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