Healthcare Provider Details

I. General information

NPI: 1316387103
Provider Name (Legal Business Name): WADE MCARTOR LADC,LCMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 10/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 FAIRFIELD ST
SAINT ALBANS VT
05478-1743
US

IV. Provider business mailing address

208 FLYNN AVE 3J
BURLINGTON VT
05401-5429
US

V. Phone/Fax

Practice location:
  • Phone: 802-488-6265
  • Fax: 802-488-6919
Mailing address:
  • Phone: 802-488-6920
  • Fax: 802-488-6919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000569
License Number StateVT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068-0079849
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: