Healthcare Provider Details

I. General information

NPI: 1689542433
Provider Name (Legal Business Name): CHARITY L BUGGIANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 SOUTH ST
PROCTOR VT
05765-9716
US

IV. Provider business mailing address

604 SOUTH ST
PROCTOR VT
05765-9716
US

V. Phone/Fax

Practice location:
  • Phone: 309-657-8021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: