Individual
MR. ANDRE JERMAINE EASON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, LCMHC
Contact information
Practice address
2225 PORTLAND ST, ST JOHNSBURY, VT 05819-8635
(802) 334-6744
Mailing address
PO BOX 62, EAST HAVEN, VT 05837-0062
(203) 721-2931
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151.0134147
VT
101YM0800X
Mental Health Counselor
068.0135630
VT
Other
Enumeration date
09/06/2022
Last updated
05/15/2024
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