Healthcare Provider Details

I. General information

NPI: 1871278499
Provider Name (Legal Business Name): EMILY ANDRADE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1138 PINE ST
BURLINGTON VT
05401-5353
US

IV. Provider business mailing address

102 S WINOOSKI AVE
BURLINGTON VT
05401-7406
US

V. Phone/Fax

Practice location:
  • Phone: 860-805-6809
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0137054
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: