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Organization
JUDEVINE PSYCHOTHERAPY
Active
Organization
JUDEVINE PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE FOSSIANO LICSW (OWNER)
(802) 760-7716
Entity
Organization
Contact information
Practice address
150 DORSET ST STE 245-169, SOUTH BURLINGTON, VT 05403-6256
(802) 760-7716
Mailing address
150 DORSET ST STE 245-169, SOUTH BURLINGTON, VT 05403-6256
(802) 760-7716
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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