Healthcare Provider Details

I. General information

NPI: 1720908106
Provider Name (Legal Business Name): ZACHARY RYAN BRIGANTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 281
BARTON VT
05822-0281
US

IV. Provider business mailing address

PO BOX 281
BARTON VT
05822-0281
US

V. Phone/Fax

Practice location:
  • Phone: 701-500-4798
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0136554
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: