MEDICARE: MICHAEL C HUNTER LCMHC, LADC

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	151.0127850	VT
2	101YM0800X	Mental Health Counselor	068.0057145	VT

General Provider Information

NPI Number	:	1376879585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL C HUNTER LCMHC, LADC

Provider Business Mailing Address
First Line	:	428 BOLTON VALLEY ACCESS RD
Second Line	:
City	:	WATERBURY
State	:	VT
Zip	:	05676-9214
Country	:	US
Telephone Number	:	802-598-5932
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 PINE HAVEN SHORES RD STE 1132
Second Line	:
City	:	SHELBURNE
State	:	VT
Zip	:	05482-7703
Country	:	US
Telephone Number	:	802-598-5932
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	02/14/2024

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