Organization
MUDDY ROAD COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LONG LICSW (OWNER)
(802) 371-9727
Entity
Organization
Contact information
Practice address
100 E STATE ST STE 201, MONTPELIER, VT 05602-3112
(802) 371-9727
Mailing address
100 E STATE ST STE 201, MONTPELIER, VT 05602-3112
(802) 371-9727
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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