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Individual

MR. ROBERT LAWRENCE GREEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
LCMHC

Contact information

Practice address
1233 SHELBURNE ROAD, SUITE D 4, SOUTH BURLINGTON, VT 05403-7753
(802) 658-2390
Mailing address
1233 SHELBURNE ROAD, SUITE D 4, SOUTH BURLINGTON, VT 05403-7753
(802) 658-2390

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000015
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1006850
VT
05
30423776
NH
01
347880
MVP
01
5062
BCBS
VT
Enumeration date
03/30/2006
Last updated
07/08/2007
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