Basic Information
Provider Information
NPI: 1710211016
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALBRECHT
FirstName: MEGHAN
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: LICSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 749
Address2:  
City: MORRISVILLE
State: VT
PostalCode: 056610749
CountryCode: US
TelephoneNumber: 8028888320
FaxNumber: 8028888136
Practice Location
Address1: 65 NORTHGATE PLAZA
Address2: SUITE 11
City: MORRISVILLE
State: VT
PostalCode: 056615900
CountryCode: US
TelephoneNumber: 8028888320
FaxNumber: 8028888136
Other Information
ProviderEnumerationDate: 09/21/2009
LastUpdateDate: 08/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X089.0104852VTY Behavioral Health & Social Service ProvidersPsychologist 
1041C0700X  N Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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