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General NPI Number Information
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NPI Number | 1265648356
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Entity Type | Individual
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Provider Name | WILLIAM MYREGAARD LCMHC
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Gender | Male
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 20 W CANAL ST STE C11
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City | WINOOSKI
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State | VT
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Zip | 05404-2147
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Country | US
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Telephone | 802-343-1158
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Fax | 802-654-8821
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Provider Business Mailing Address
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Address Line | 112 VALLEY VIEW RD
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City | RICHMOND
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State | VT
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Zip | 05477-9197
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Country | US
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Telephone | 802-343-1158
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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 | 068-0000274
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License Number State | VT
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