Provider Demographics
NPI:1053140921
Name:BAUDREAU COUNSELING AND PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:BAUDREAU COUNSELING AND PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:ALICE
Authorized Official - Last Name:BAUDREAU
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-316-8717
Mailing Address - Street 1:150 DORSET ST SUITE 245
Mailing Address - Street 2:PMB 247
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-316-8717
Mailing Address - Fax:
Practice Address - Street 1:373 BLAIR PARK RD UNIT 206
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-8056
Practice Address - Country:US
Practice Address - Phone:802-316-8717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty