IndividualActive
Alexander Lodge, MA
NPI 1720700404 · Psychologist · Williston, VT
Provider details
- NPI number
- 1720700404
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- MA
- Sex
- Male
- Sole proprietor
- Yes
- License
- 047.0133699 (VT)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Behavioral Health & Social Service Providers
Practice location
75 Talcott Rd Ste 30
Williston, VT 05495-8122
Phone: (802) 503-2929
Approximate (ZIP-level) locationGet directions
Mailing address
629 Metcalf Dr
Williston, VT 05495-8802
Registry dates
- Enumerated
- 2022-09-19
- Last updated
- 2024-01-29
- Certified
- 2024-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.