Coventry, Mary G.
Coventry, Mary G. is an individual health care provider with primary practice located at 51 Fairview Street , Brattleboro VT 05301-6629. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Coventry, Mary G. can be contacted via phone (802) 254-6028.Contact Information
Primary practice address
51 Fairview Street
Brattleboro VT 05301-6629
Phone: (802) 254-6028
Fax: (802) 254-7501
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 068-0134112 | Vermont |
Profile Details
| NPI number | 1053792929 |
|---|---|
| LBN Legal business name | Coventry, Mary G. |
| Credentials | MA LCMHC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2015 |
| Last updated | Sep 20th, 2019 - about 7 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 | 1053792929 | NPPES |
| Vermont | MEDICAID | 1034763 |
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