Healthcare Provider Details

I. General information

NPI: 1679322945
Provider Name (Legal Business Name): SETH HAXEL MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 W TWIN OAKS TER STE 5
SOUTH BURLINGTON VT
05403-7138
US

IV. Provider business mailing address

242 OLD STAGE RD
ESSEX JUNCTION VT
05452-2522
US

V. Phone/Fax

Practice location:
  • Phone: 607-260-3100
  • Fax: 607-241-9972
Mailing address:
  • Phone: 434-989-2756
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: