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
Phone: (802) 728-4466
Fax: (802) 728-4197
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1023194925 | NPPES |
| Vermont | MEDICAID | 1007038 | |
| Vermont | Other | 19428 | |
| Vermont | Other | 14Y001678VT01 | |
| Vermont | Other | 1041581 |
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