Healthcare Provider Details

I. General information

NPI: 1811887870
Provider Name (Legal Business Name): FIELDSTONE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 SAXTONS RIVER RD
SAXTONS RIVER VT
05154-9701
US

IV. Provider business mailing address

940 SAXTONS RIVER RD
SAXTONS RIVER VT
05154-9701
US

V. Phone/Fax

Practice location:
  • Phone: 802-376-1516
  • Fax:
Mailing address:
  • Phone: 802-376-1516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL MARTIN
Title or Position: OWNER/THERAPIST
Credential: LICSW MSW
Phone: 802-376-1516