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General NPI Number Information
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NPI Number | 1881495596
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Entity Type | Organization
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Legal Business Name | EDMONDSON COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 149 STATE ST
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City | MONTPELIER
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State | VT
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Zip | 05602-2965
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Country | US
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Telephone | 802-522-9211
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Fax |
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Provider Business Mailing Address
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Address Line | 28 RIDGEWOOD TER
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City | BARRE
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State | VT
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Zip | 05641-9738
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Country | US
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Telephone | 802-522-9211
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Fax |
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Authorized Official
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Title or Position | OWNER/LCMHC
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Name | JACOB EDMONDSON
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Credential | MA
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Telephone | 802-522-9211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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