Individual
MR. ELLIOTT BUELTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
156 JOHNSON STREET EXT, HYDE PARK, VT 05655-9354
(802) 851-0301
Mailing address
156 JOHNSON STREET EXT, HYDE PARK, VT 05655-9354
(401) 714-4930
(401) 712-8659
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0134300
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6705170
—
VT
Enumeration date
01/09/2017
Last updated
04/27/2021
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