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Individual

JENNIFER WEADOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LADC, LCPC, LAC

Contact information

Practice address
73 MAIN ST APT 27, MONTPELIER, VT 05602-2987
(802) 585-0230
Mailing address
40 KINGSWOOD DR, MILTON, VT 05468-3175
(802) 585-0230

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151.0134175
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-64684
MT
101YM0800X
Mental Health Counselor
BBH-LCPC-70407
MT

Other

Enumeration date
04/18/2022
Last updated
04/30/2024
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