MEDICARE: DR. CHRISTOPHER JOHN SERNAQUE EDD, RP

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	101YM0800X	Mental Health Counselor	097.0136861	VT

General Provider Information

NPI Number	:	1841962438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER JOHN SERNAQUE EDD, RP

Provider Business Mailing Address
First Line	:	861 WILLISTON RD STE 8
Second Line	:
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-5724
Country	:	US
Telephone Number	:	813-591-0761
Fax Number	:

Provider Business Practice Location Address
First Line	:	861 WILLISTON RD STE 8
Second Line	:
City	:	SOUTH BURLINGTON
State	:	VT
Zip	:	05403-5724
Country	:	US
Telephone Number	:	813-591-0761
Fax Number	:

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

Provider Enumeration Date	:	10/01/2021
Last Update Date	:	02/25/2026

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