Nickerson, Debra H
Nickerson, Debra H is an individual health care provider with primary practice located at 1138 Pine St , Burlington VT 05401-5353. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Nickerson, Debra H can be contacted via phone (802) 488-6600.Contact Information
Primary practice address
1138 Pine St
Burlington VT 05401-5353
Phone: (802) 488-6600
Fax: (802) 488-6919
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 089-0000945 | Vermont |
Profile Details
| NPI number | 1518029479 |
|---|---|
| LBN Legal business name | Nickerson, Debra H |
| Credentials | LICSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 15th, 2006 |
| Last updated | May 13th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518029479 | NPPES |
| Vermont | MEDICAID | 1014509 |
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