Organization
SANDROCK COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALA GILLIM LCMHC (OWNER)
(802) 373-7030
Entity
Organization
Contact information
Practice address
595 DORSET ST STE 5, SOUTH BURLINGTON, VT 05403-6240
(802) 373-7030
Mailing address
PO BOX 123, CAMBRIDGE, VT 05444-0123
(802) 373-7030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639817844
INDIVIDUAL NPI
—
Enumeration date
06/02/2022
Last updated
06/24/2022
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