Healthcare Provider Details

I. General information

NPI: 1316814924
Provider Name (Legal Business Name): COURTNEY CIOFFREDI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 MAPLE ST STE 14
MIDDLEBURY VT
05753-1231
US

IV. Provider business mailing address

PO BOX 10
BRISTOL VT
05443-0010
US

V. Phone/Fax

Practice location:
  • Phone: 802-233-9057
  • Fax:
Mailing address:
  • Phone: 802-233-9057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number097.013634
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: