MEDICARE: KEVIN J LENFEST MS, LADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	151.0127348	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	9801673	OTHER	MVP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4780099	OTHER	CIGNA

General Provider Information

NPI Number	:	1700130051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN J LENFEST MS, LADC

Provider Business Mailing Address
First Line	:	128 VT ROUTE 7B NORTH EXT
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-9529
Country	:	US
Telephone Number	:	802-747-8812
Fax Number	:	844-878-0102

Provider Business Practice Location Address
First Line	:	128 VT ROUTE 7B NORTH EXT
Second Line	:
City	:	NORTH CLARENDON
State	:	VT
Zip	:	05759-9529
Country	:	US
Telephone Number	:	802-747-8812
Fax Number	:	844-878-0102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2012
Last Update Date	:	04/20/2023

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