Individual
ELLEN B. GLUCKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6971 MAIN ST STE 3, WAITSFIELD, VT 05673-6223
(802) 595-5272
Mailing address
1444 AIRPORT RD, MORETOWN, VT 05660-9225
(802) 595-5272
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000607
VT
101YM0800X
Mental Health Counselor
Primary
068.0053633
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427496066
—
VT
Enumeration date
06/05/2013
Last updated
03/23/2015
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