Basic Information
Provider Information
NPI: 1285065284
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALTERMATT
FirstName: ERIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LCMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SWEENEY
OtherFirstName: ERIN
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: LCMHC
OtherLastNameType: 1
Mailing Information
Address1: 208 FLYNN AVE
Address2: SUITE 3J
City: BURLINGTON
State: VT
PostalCode: 054015429
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1138 PINE ST
Address2:  
City: BURLINGTON
State: VT
PostalCode: 054015353
CountryCode: US
TelephoneNumber: 8024886600
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/02/2013
LastUpdateDate: 01/23/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X068-0000459VTY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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