Healthcare Provider Details

I. General information

NPI: 1346463197
Provider Name (Legal Business Name): BENJAMIN WALDEN FOX MA, MHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 COLLINS DR
MIDDLEBURY VT
05753-8502
US

IV. Provider business mailing address

44 COLLINS DR
MIDDLEBURY VT
05753-8502
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-7959
  • Fax: 802-388-8136
Mailing address:
  • Phone: 802-388-7959
  • Fax: 802-388-8136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068.0057628
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: