Fortier, Susan M

Fortier, Susan M is an individual health care provider with primary practice located at 100 Mansfield Ave , Burlington VT 05401-3322. She recently has only one registered license in Behavioral Health & Social Service Providers / Adult Development & Aging, which is considered as her primary health care specialty. Fortier, Susan M can be contacted via phone (802) 734-5876.

Contact Information

Primary practice address
100 Mansfield Ave Burlington VT 05401-3322
Phone: (802) 734-5876
Fax: (802) 489-5294
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Adult Development & Aging 103TA0700X 0480000609 Vermont

Profile Details

NPI number 1871519520
LBN Legal business name Fortier, Susan M
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2006
Last updated Nov 20th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871519520 NPPES
Vermont MEDICAID 0VN1431
Vermont Other 28128
Vermont Other 41402

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