Pellegrino, David

Pellegrino, David is an sole proprietor health care provider with primary practice located at 11 S Main St , Randolph VT 05060-1330. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Pellegrino, David can be contacted via phone (802) 728-4466.

Contact Information

Primary practice address
11 S Main St Randolph VT 05060-1330
Fax: (802) 728-4197
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 068-0000170 Vermont

Profile Details

NPI number 1023194925
LBN Legal business name Pellegrino, David
Credentials LCMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 31st, 2006
Last updated Jul 9th, 2007 - about 19 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 1023194925 NPPES
Vermont MEDICAID 1007038
Vermont Other 19428
Vermont Other 14Y001678VT01
Vermont Other 1041581

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