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NPI 1619502648

NPI 1619502648 : KATHLEEN E BAROODY LCMHC, NCC : RUTLAND, VT

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General NPI Number Information
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    NPI Number           |    1619502648
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    Entity Type          |    Individual 
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    Provider Name        |    KATHLEEN E BAROODY LCMHC, NCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/10/2020
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    Last Update Date     |    09/25/2025
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Provider Practice Location Address
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    Address Line         |    77 GROVE ST 
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    City                 |    RUTLAND
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    State                |    VT
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    Zip                  |    05701-3403
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    Country              |    US
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    Telephone            |    843-379-9675
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    187 COUNTRYSIDE DR 
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    City                 |    RUTLAND
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    State                |    VT
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    Zip                  |    05701-9313
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    Country              |    US
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    Telephone            |    407-312-9781
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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       |    068.0134451
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    License Number State |    VT
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