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Individual

MS. LISA JILL CARTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
504A MAIN ST, SUITE 2, BENNINGTON, VT 05201-2111
(802) 479-5456
Mailing address
149 IMPERIAL AVE, BENNINGTON, VT 05201-2476
(802) 379-5456

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890000940
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1009542
VT
01
2044751
CIGNA PROV NUMBER
VT
01
59257
BC/BS OF VT PROVIDER NUMB
VT
01
698763
MVP PROV NUMBER
VT
Enumeration date
09/28/2006
Last updated
08/09/2012
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