Healthcare Provider Details

I. General information

NPI: 1932120458
Provider Name (Legal Business Name): LORI M VADAKIN LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CHURCH ST
ARLINGTON VT
05250-4457
US

IV. Provider business mailing address

20 WEST STREET
N BENNINGTON VT
05257
US

V. Phone/Fax

Practice location:
  • Phone: 802-375-6566
  • Fax:
Mailing address:
  • Phone: 802-733-6585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000257
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000257
License Number StateVT
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number000257
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: