Provider Demographics
NPI:1548726649
Name:KINGDOM COUNSELING LLC
Entity type:Organization
Organization Name:KINGDOM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:LUCIER
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:802-505-5803
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:BEEBE PLAIN
Mailing Address - State:VT
Mailing Address - Zip Code:05823-0066
Mailing Address - Country:US
Mailing Address - Phone:802-505-5803
Mailing Address - Fax:
Practice Address - Street 1:209 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-5534
Practice Address - Country:US
Practice Address - Phone:802-334-7921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty