Basic Information
Provider Information
NPI: 1992877757
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BELAIR
FirstName: SHERI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: TRIPLETT
OtherFirstName: SHERI
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1138 PINE ST
Address2:  
City: BURLINGTON
State: VT
PostalCode: 054015353
CountryCode: US
TelephoneNumber: 8028631326
FaxNumber: 8026603665
Practice Location
Address1: 1138 PINE ST
Address2:  
City: BURLINGTON
State: VT
PostalCode: 054015353
CountryCode: US
TelephoneNumber: 8028631326
FaxNumber: 8026603665
Other Information
ProviderEnumerationDate: 11/15/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X VTY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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