Healthcare Provider Details

I. General information

NPI: 1225103534
Provider Name (Legal Business Name): KATHERINE M DUHAMEL MA LADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/03/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 SCHOOL STREET
HARTFORD VT
05047
US

IV. Provider business mailing address

390 RIVER STREET
SPRINGFIELD VT
05156
US

V. Phone/Fax

Practice location:
  • Phone: 802-295-3031
  • Fax: 802-886-4520
Mailing address:
  • Phone: 802-886-4500
  • Fax: 802-886-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number151.0125844
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: