Healthcare Provider Details

I. General information

NPI: 1033070966
Provider Name (Legal Business Name): JENAL DUMAS LADC, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 DORSET ST STE 245
SOUTH BURLINGTON VT
05403-6238
US

IV. Provider business mailing address

150 DORSET ST. STE 245 PMB 258
SOUTH BURLINGTON VT
05403
US

V. Phone/Fax

Practice location:
  • Phone: 802-338-2977
  • Fax: 802-209-5388
Mailing address:
  • Phone: 802-338-2977
  • Fax: 802-209-5388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number089.0137247
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number151.0134222
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: