Healthcare Provider Details

I. General information

NPI: 1659234987
Provider Name (Legal Business Name): SAJA WILLARD MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86 LAKE ST STE 220
BURLINGTON VT
05401-5297
US

IV. Provider business mailing address

86 LAKE ST STE 220
BURLINGTON VT
05401-5297
US

V. Phone/Fax

Practice location:
  • Phone: 802-265-0307
  • Fax:
Mailing address:
  • Phone: 802-265-0307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0136590
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: