Individual
MS. KATHARINE B LUSCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
3 MAIN ST, SUITE 213, BURLINGTON, VT 05401-5216
(802) 863-0220
(802) 863-0444
Mailing address
320 OLD GULF RD, MORETOWN, VT 05660-9112
(802) 496-7128
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000066
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007079
—
VT
01
—
102494
MAGELLAN OF MASS.
VT
01
—
18413
BC/BS OF VT
VT
01
—
610245
MVP
VT
01
—
7607450
AETNA
VT
Enumeration date
09/01/2006
Last updated
07/08/2007
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