Organization
KILLY BASCOM, LICSW, PLLC
Active
Other names
Village Couseling Associates
Organization subpart
No
Provider details
NPI number
Authorized official
KILLY BASCOM LICSW (OWNER)
(802) 662-1655
Entity
Organization
Contact information
Practice address
1222 PUTNEY RD, BRATTLEBORO, VT 05301-9000
(802) 662-1655
Mailing address
PO BOX 8473, BRATTLEBORO, VT 05304-8473
(802) 662-1655
(802) 662-1655
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890087148
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021358
—
VT
Enumeration date
08/03/2015
Last updated
09/02/2025
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