MEDICARE: GRACE CENEDELLA 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
1	101YM0800X	Mental Health Counselor	097.0136408	VT

General Provider Information

NPI Number	:	1386514826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE CENEDELLA LCMHC

Provider Business Mailing Address
First Line	:	305 SAINT PAUL ST STE 323
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-5073
Country	:	US
Telephone Number	:	802-222-0436
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 SAINT PAUL ST STE 323
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-5073
Country	:	US
Telephone Number	:	802-222-0436
Fax Number	:

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

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	11/10/2025

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Directions to “ GRACE CENEDELLA LCMHC” Practice Location

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