Organization
PSYIPSUM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL O'TOOLE (OWNER)
(802) 497-2187
Entity
Organization
Contact information
Practice address
278 COLLEGE ST, BURLINGTON, VT 05401-8319
(802) 497-2187
Mailing address
278 COLLEGE ST, BURLINGTON, VT 05401-8319
(802) 497-2187
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
01/10/2025
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