Provider Demographics
NPI:1780908251
Name:COLUMBIA, ERIN POUTRE (LCMHC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:POUTRE
Last Name:COLUMBIA
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:DONNA
Other - Last Name:POUTRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 724
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-0724
Mailing Address - Country:US
Mailing Address - Phone:802-334-6744
Mailing Address - Fax:802-334-7340
Practice Address - Street 1:154 DUCHESS AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-5516
Practice Address - Country:US
Practice Address - Phone:802-334-6744
Practice Address - Fax:802-334-7340
Is Sole Proprietor?:No
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680057732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health