Individual
MR. DEAN MARK CORCORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
220 RAILROAD STREET, ST. JOHNSBURY, VT 05819
(802) 748-1516
(802) 748-1516
Mailing address
1423 PEACHAM DANVILLE RD, BARNET, VT 05821-9400
(802) 748-1516
(802) 748-1516
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
068-0000422
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
000053
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007051
—
VT
Enumeration date
09/05/2006
Last updated
12/09/2015
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