Healthcare Provider Details

I. General information

NPI: 1902877954
Provider Name (Legal Business Name): PHYLLIS A SATINK MS, APRN, CS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2006
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 POKER HILL RD
UNDERHILL VT
05489-9383
US

IV. Provider business mailing address

425 POKER HILL RD
UNDERHILL VT
05489-9383
US

V. Phone/Fax

Practice location:
  • Phone: 802-373-1386
  • Fax: 877-852-2315
Mailing address:
  • Phone: 802-373-1386
  • Fax: 877-852-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number101-0008503
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number068-0000082
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: