Healthcare Provider Details
I. General information
NPI: 1124825799
Provider Name (Legal Business Name): DAWN CHORUS PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/28/2025
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
351 N CALAIS RD
EAST CALAIS VT
05650-8063
US
IV. Provider business mailing address
480 CLIF REYNOLDS RD
JEFFERSONVILLE VT
05464-9474
US
V. Phone/Fax
- Phone: 845-392-5510
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
STEVEN
LILLY
Title or Position: OWNER
Credential: LCMHC
Phone: 845-392-5510