# JUDEVINE PSYCHOTHERAPY

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316864457
- **Authorized official:** NICOLE FOSSIANO LICSW (OWNER)
- **Authorized official phone:** (802) 760-7716

## Contact information

- **Practice address:** 150 DORSET ST STE 245-169, SOUTH BURLINGTON, VT 05403-6256
- **Practice address phone:** (802) 760-7716
- **Mailing address:** 150 DORSET ST STE 245-169, SOUTH BURLINGTON, VT 05403-6256
- **Mailing address phone:** (802) 760-7716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2026
- **Last updated:** 06/30/2026