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NPI Code Detail

MEDICARE: HAYDEN R ELMENDORF LCMHC

MEDICARE: HAYDEN R ELMENDORF LCMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor068.0134761VT

General Provider Information

NPI Number : 1174251342
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAYDEN R ELMENDORF LCMHC
Provider Business Mailing Address
First Line : PO BOX 647
Second Line :
City : MONTPELIER
State : VT
Zip : 05601-0647
Country : US
Telephone Number : 802-828-3983
Fax Number : 802-223-0842
Provider Business Practice Location Address
First Line : 34 BARRE ST
Second Line :
City : MONTPELIER
State : VT
Zip : 05602-3510
Country : US
Telephone Number : 802-828-3983
Fax Number : 802-223-0842
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2022
Last Update Date : 09/06/2022

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Directions to “ HAYDEN R ELMENDORF LCMHC” Practice Location

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