Provider Demographics
NPI:1538235361
Name:DAVID HUESMAN INC
Entity type:Organization
Organization Name:DAVID HUESMAN INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW LADC
Authorized Official - Phone:802-658-4208
Mailing Address - Street 1:PO BOX 156
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:VT
Mailing Address - Zip Code:05655-0156
Mailing Address - Country:US
Mailing Address - Phone:802-888-3429
Mailing Address - Fax:
Practice Address - Street 1:34 PATCHEN RD
Practice Address - Street 2:
Practice Address - City:S BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-658-4208
Practice Address - Fax:802-658-2234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000118101YA0400X
VT08900003761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT19077OtherBLUE CROS BLUE SHIELD
VTOVN0958Medicaid
VTHUVN0958Medicare ID - Type Unspecified