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General NPI Number Information
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NPI Number | 1013787993
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Entity Type | Individual
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Provider Name | SARAH M BUCKINGHAM
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Gender | Female
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Dates
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Enumeration Date | 01/03/2024
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Last Update Date | 01/03/2024
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Provider Practice Location Address
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Address Line | 39 THE SQ STE 202
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City | BELLOWS FALLS
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State | VT
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Zip | 05101-1364
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Country | US
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Telephone | 802-289-8153
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Fax |
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Provider Business Mailing Address
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Address Line | 123 TAYLOR RD
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City | WESTMINSTER WEST
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State | VT
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Zip | 05346-9019
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Country | US
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Telephone | 614-905-6955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 097.0136045
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License Number State | VT
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