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Individual

MARIANNE PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCMHC, LADC

Contact information

Practice address
855 PINE ST, BURLINGTON, VT 05401-4924
(802) 488-6103
(802) 488-6919
Mailing address
208 FLYNN AVE, 3J, BURLINGTON, VT 05401-5429
(802) 488-6900
(802) 488-6919

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000189
VT
101YM0800X
Mental Health Counselor
068-0000617
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1010732
VT
Enumeration date
07/06/2006
Last updated
05/16/2011
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