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Individual

MR. ROBERT A PELOSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NCC., LCMHC

Contact information

Practice address
610 VERMONT RTE 100, JACKSONVILLE, VT 05342
(802) 368-2220
(802) 368-2220
Mailing address
PO BOX 416, WILMINGTON, VT 05363-0416
(802) 464-0543
(802) 464-0543

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
004004
NY
101YM0800X
Mental Health Counselor
068.0089265
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1014830
VT
01
600499496
BCBS
VT
Enumeration date
02/27/2007
Last updated
09/13/2012
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