Healthcare Provider Details

I. General information

NPI: 1427911031
Provider Name (Legal Business Name): GISELLE PALACIOS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 COLLEGE ST
BURLINGTON VT
05401-8476
US

IV. Provider business mailing address

401 SAINT PAUL ST
BURLINGTON VT
05401-5621
US

V. Phone/Fax

Practice location:
  • Phone: 802-265-6909
  • Fax: 802-451-0400
Mailing address:
  • Phone: 802-265-6909
  • Fax: 802-451-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0136069
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: