MEDICARE: LORI M VADAKIN 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	000257	VT
2	101YM0800X	Mental Health Counselor	000257	VT
3	101Y00000X	Counselor	000257	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	59046	OTHER		BLUE CROSS
2	2084921	OTHER		CIGNA

General Provider Information

NPI Number	:	1932120458
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI M VADAKIN LADC

Provider Business Mailing Address
First Line	:	20 WEST STREET
Second Line	:
City	:	N BENNINGTON
State	:	VT
Zip	:	05257
Country	:	US
Telephone Number	:	802-733-6585
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 CHURCH ST
Second Line	:
City	:	ARLINGTON
State	:	VT
Zip	:	05250-4457
Country	:	US
Telephone Number	:	802-375-6566
Fax Number	:

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	08/15/2025

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