Healthcare Provider Details

I. General information

NPI: 1366825846
Provider Name (Legal Business Name): SARA JANE LUNEAU LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SARA LUNEAU-SWAN LCMHC

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 SCHOOL ROAD
JEFFERSONVILLE VT
05464
US

IV. Provider business mailing address

2998 SWEET HOLLOW ROAD
SHELDON VT
05483-8421
US

V. Phone/Fax

Practice location:
  • Phone: 802-598-1616
  • Fax:
Mailing address:
  • Phone: 802-598-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0090868
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: