Provider Demographics
NPI:1730276346
Name:KESSLER, RODGER S (PHD)
Entity type:Individual
Prefix:DR
First Name:RODGER
Middle Name:S
Last Name:KESSLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MERRILL HILL RD
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4554
Mailing Address - Country:US
Mailing Address - Phone:802-253-9944
Mailing Address - Fax:
Practice Address - Street 1:301 FISHER ROAD
Practice Address - Street 2:SUITE 3-1
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602
Practice Address - Country:US
Practice Address - Phone:802-225-7000
Practice Address - Fax:802-225-7103
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT233103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1001191Medicaid
VTVT9746Medicare ID - Type Unspecified
VT1001191Medicaid