Healthcare Provider Details

I. General information

NPI: 1891659918
Provider Name (Legal Business Name): HANNAH CUSEO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

444 S UNION ST UNIT C4
BURLINGTON VT
05401-4859
US

IV. Provider business mailing address

PO BOX 8064
ESSEX VT
05451-8064
US

V. Phone/Fax

Practice location:
  • Phone: 802-316-8736
  • Fax:
Mailing address:
  • Phone: 802-316-8736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.0135973
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: