Healthcare Provider Details

I. General information

NPI: 1396752994
Provider Name (Legal Business Name): JENNIFER ANN AULETTA MA, LCMHC, DTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/18/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CVMC, OB/GYN/MIDWIFERY, BLDG A, SUITE 1-4 130 FISHER ROAD
BARRE VT
05641-4124
US

IV. Provider business mailing address

148 BARRE ST
MONTPELIER VT
05602-3671
US

V. Phone/Fax

Practice location:
  • Phone: 802-371-5961
  • Fax: 802-371-5960
Mailing address:
  • Phone: 802-279-5809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0000665
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068-0000665
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: