Healthcare Provider Details

I. General information

NPI: 1972312122
Provider Name (Legal Business Name): KATHERINE SCHLAGETER PSYD PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 01/02/2025
Certification Date: 12/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5429 MAIN ST.
MANCHESTER CENTER VT
05255
US

IV. Provider business mailing address

PO BOX 1607
MANCHESTER CENTER VT
05255-1607
US

V. Phone/Fax

Practice location:
  • Phone: 802-379-4224
  • Fax:
Mailing address:
  • Phone: 802-379-4224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATHERINE SCHLAGETER
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 802-379-4224