Individual
COLLEEN DWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
617 RIVERSIDE AVE, BURLINGTON, VT 05401-1601
(802) 864-6309
(802) 860-4324
Mailing address
81 WILLARD STREET, BURLINGTON, VT 05401
(802) 862-8172
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000995
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010437
—
VT
01
—
2202425
CIGNA BEHAVIORAL HEALTH
—
01
—
576759
VALUE OPTIONS
—
01
—
68164
BLUE CROSS BLUE SHIELD
VT
Enumeration date
09/25/2006
Last updated
07/08/2007
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