Healthcare Provider Details

I. General information

NPI: 1255427001
Provider Name (Legal Business Name): SOJOURNS COMMUNITY CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4923 US ROUTE 5
WESTMINSTER VT
05158-9651
US

IV. Provider business mailing address

4923 US ROUTE 5
WESTMINSTER VT
05158-9651
US

V. Phone/Fax

Practice location:
  • Phone: 802-722-4023
  • Fax: 802-387-0275
Mailing address:
  • Phone: 802-722-4023
  • Fax: 802-387-0275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SUSANNE BOOTH
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 802-722-4023