Healthcare Provider Details

I. General information

NPI: 1538235361
Provider Name (Legal Business Name): DAVID HUESMAN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PATCHEN RD
S BURLINGTON VT
05403
US

IV. Provider business mailing address

PO BOX 156
HYDE PARK VT
05655-0156
US

V. Phone/Fax

Practice location:
  • Phone: 802-658-4208
  • Fax: 802-658-2234
Mailing address:
  • Phone: 802-888-3429
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0890000376
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000118
License Number StateVT

VIII. Authorized Official

Name: MR. DAVID J HUESMAN
Title or Position: PRESIDENT
Credential: LICSW LADC
Phone: 802-658-4208