Individual
DEREK ANDREW GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, LADC
Contact information
Practice address
55 JOY DR, SOUTH BURLINGTON, VT 05403-6119
(802) 658-6111
Mailing address
28 CONVENT SQ, BURLINGTON, VT 05401-5136
(802) 578-7870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000391
VT
1041C0700X
Clinical Social Worker
Primary
089.0000978
VT
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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