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Northeast Kingdom Trauma Intensives
Adolescent and Children Mental Health Clinic/Center in St Johnsbury, Vermont
NPI 1629792114

Northeast Kingdom Trauma Intensives is an Adolescent and Children Mental Health Clinic/Center based in Lyndonville, VT and is specialized in Adolescent and Children Mental Health. Northeast Kingdom Trauma Intensives practices in St Johnsbury, VT. The NPI Number for Northeast Kingdom Trauma Intensives is 1629792114 and holds a License No. (Vermont).

The current practice location address for Northeast Kingdom Trauma Intensives is 293 Pearl St Ste 101, St Johnsbury, VT and can be reached out via phone at 802-327-5902.

Location: 293 Pearl St Ste 101, St Johnsbury, VT, 05851-8530
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1629792114
Provider Name
Northeast Kingdom Trauma Intensives
Credential
Provider Entity Type
Organization
Address
293 Pearl St Ste 101, St Johnsbury, VT, 05851-8530
Phone Number
802-327-5902
Fax Number
Provider Enumeration Date
09/28/2022
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
293 Pearl St Ste 101
City
St Johnsbury
State
Vermont
Zip
05819-5641
Phone Number
802-327-5902
Fax Number
person
Provider Business Mailing Address Details
Address
293 Pearl St Ste 101
City
St Johnsbury
State
Vermont
Zip
05819-5641
Phone Number
802-327-5902
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
()
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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