Healthcare Provider Details

I. General information

NPI: 1689591604
Provider Name (Legal Business Name): COUNSELING SERVICE OF ADDISON COUNTY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 LOTSAWATER RD
SALISBURY VT
05769-9658
US

IV. Provider business mailing address

89 MAIN ST
MIDDLEBURY VT
05753-1483
US

V. Phone/Fax

Practice location:
  • Phone: 802-388-4885
  • Fax:
Mailing address:
  • Phone: 802-388-6751
  • Fax: 802-388-1868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: EMILY ANN VANDEWEERT
Title or Position: CLIENT HEALTH OPER & BILLING MGR.
Credential:
Phone: 802-388-6751