Healthcare Provider Details

I. General information

NPI: 1386763225
Provider Name (Legal Business Name): SYNERGY COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CLOVER LN
JERICHO VT
05465-3129
US

IV. Provider business mailing address

2 CLOVER LN
JERICHO VT
05465-3129
US

V. Phone/Fax

Practice location:
  • Phone: 802-225-5924
  • Fax: 802-858-0027
Mailing address:
  • Phone: 802-225-5924
  • Fax: 802-858-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number000099
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateVT

VIII. Authorized Official

Name: MR. WARREN JAMES HAMEL
Title or Position: OWNER
Credential: LADC, CADC
Phone: 802-225-5924