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General NPI Number Information
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NPI Number | 1285805762
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Entity Type | Individual
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Provider Name | STACY D'LYNN EGGSWARE MC, LPC, LCMHC
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Gender | Female
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Dates
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Enumeration Date | 03/12/2008
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 655 MAIN ST
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City | BENNINGTON
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State | VT
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Zip | 05201-2870
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Country | US
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Telephone | 802-494-4040
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Fax | 602-491-2119
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Provider Business Mailing Address
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Address Line | 655 MAIN ST STE 5
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City | BENNINGTON
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State | VT
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Zip | 05201-2871
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Country | US
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Telephone | 802-494-4040
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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 | LPC-11745
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License Number State | AZ
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