Individual
SARA DEGENNARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCMHC, LADC,CCS
Contact information
Practice address
211 N MAIN ST, SUITE B, WHITE RIVER JUNCTION, VT 05001-7045
(802) 233-8755
(802) 295-8833
Mailing address
PO BOX 576, ASCUTNEY, VT 05030
(802) 295-0755
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000059
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
0600
NH
101YM0800X
Mental Health Counselor
0680000181
VT
101YM0800X
Mental Health Counselor
374
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006714
—
VT
01
—
29434
MH BC/BS
VT
05
—
30422317
—
NH
05
—
3100214
—
NH
01
—
49993
SA BC/BS
VT
Enumeration date
05/09/2006
Last updated
10/13/2015
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