Healthcare Provider Details
I. General information
NPI: 1275677338
Provider Name (Legal Business Name): VERMONT ACADEMY COUNSELING DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/20/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 PLEASANT STREET
SAXTONS RIVER VT
05154
US
IV. Provider business mailing address
20 PLEASANT STREET
SAXTONS RIVER VT
05154
US
V. Phone/Fax
- Phone: 802-869-6243
- Fax:
- Phone: 802-869-6243
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | VT |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041S0200X |
| Taxonomy | School Social Worker |
| License Number | |
| License Number State | VT |
VIII. Authorized Official
Name: MR.
RICHARD
BERNASCO
Title or Position: CFO
Credential:
Phone: 802-869-6243