Healthcare Provider Details

I. General information

NPI: 1407795537
Provider Name (Legal Business Name): SAFE HARBOR WELLNESS COLLECTIVE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 UNION ST
BENNINGTON VT
05201-3102
US

IV. Provider business mailing address

211 UNION ST APT 6
BENNINGTON VT
05201-3102
US

V. Phone/Fax

Practice location:
  • Phone: 518-495-4474
  • Fax:
Mailing address:
  • Phone: 518-495-4474
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE HULL
Title or Position: CO-OWNER
Credential: LICSW
Phone: 518-495-4474