Healthcare Provider Details

I. General information

NPI: 1275303463
Provider Name (Legal Business Name): SARAH MARGARET STORJOHANN LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH MARGARET WILSON

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 09/23/2024
Certification Date: 01/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 VILLAGE RD
EAST CORINTH VT
05040
US

IV. Provider business mailing address

4628 MAIN ST S
NEWBURY VT
05051-9712
US

V. Phone/Fax

Practice location:
  • Phone: 802-439-5321
  • Fax:
Mailing address:
  • Phone: 802-222-3000
  • 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: