Healthcare Provider Details

I. General information

NPI: 1881405892
Provider Name (Legal Business Name): MARY-LYNN GAREY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 CRAWFORD RD.
DERBY VT
05829
US

IV. Provider business mailing address

87 WASHINGTON ST
CONWAY NH
03818-6044
US

V. Phone/Fax

Practice location:
  • Phone: 802-334-6744
  • Fax:
Mailing address:
  • Phone: 603-447-3347
  • 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:
Title or Position:
Credential:
Phone: