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General NPI Number Information
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NPI Number | 1841442365
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Entity Type | Individual
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Provider Name | CAITLIN WAGNER KINNART MS, PHD, LCMHC, LADC
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Gender | Female
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Dates
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Enumeration Date | 10/15/2008
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 182 MAIN ST
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City | BURLINGTON
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State | VT
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Zip | 05401-8349
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Country | US
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Telephone | 802-448-2347
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1001
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City | SHELBURNE
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State | VT
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Zip | 05482-1001
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Country | US
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Telephone | 802-448-2347
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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 | 068.0057702
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 151.0125860
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License Number State | VT
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