Healthcare Provider Details

I. General information

NPI: 1982989661
Provider Name (Legal Business Name): BLAIR DANZ LPC,LCMHC,SUPERVISOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2011
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MAIN ST
SPRINGFIELD VT
05156-2935
US

IV. Provider business mailing address

1 MAIN ST STE A
SPRINGFIELD VT
05156-2935
US

V. Phone/Fax

Practice location:
  • Phone: 802-373-4584
  • Fax: 802-341-6568
Mailing address:
  • Phone: 802-373-4584
  • Fax: 802-341-6568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number67393
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: