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Individual

LEE CRIDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
50 GRANVIEW DR, BARRE, VT 05641-5113
(802) 479-2502
Mailing address
PO BOX 647, MONTPELIER, VT 05601-0647
(802) 479-2502

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089-0000482
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00029836
BC/BS OF VERMONT
VT
05
1007325
VT
01
2078940
CIGNA
VT
01
360274
TRICARE
VT
01
989026C
MVP HEALTHCARE
VT
Enumeration date
07/19/2006
Last updated
04/06/2010
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