=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932032182
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HER SECOND ACT COUNSELING SERVICES PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2026
-----------------------------------------------------
Last Update Date | 06/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 60 WINDY VALLEY RD
-----------------------------------------------------
City | BRIDPORT
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05734-9641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-771-4024
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 288
-----------------------------------------------------
City | MIDDLEBURY
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05753-0288
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | LAURA ETHIER
-----------------------------------------------------
Credential | LICSW, LADC
-----------------------------------------------------
Telephone | 802-771-4024
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------