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Individual

SUSAN LEE PIERCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
(802) 442-4910
Mailing address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
089-0000665
VT
104100000X
Social Worker
089-0000665
VT
1041C0700X
Clinical Social Worker
Primary
089-0000665
VT
1041S0200X
School Social Worker
089-0000665
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1007303
VT
01
2018856
CIGNA
01
360768
MANAGED HEALTH NET
01
38183
BLUE CROSS
Enumeration date
08/05/2006
Last updated
10/02/2015
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