Individual
JACQUELINE F ESANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LCMHC, LPC
Contact information
Practice address
30 WILSON RD, FAIRFAX, VT 05454-4409
(802) 255-8801
(802) 491-8230
Mailing address
30 WILSON RD, FAIRFAX, VT 05454-4409
(802) 255-8801
(802) 491-8230
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151-0134045
VT
101YM0800X
Mental Health Counselor
Primary
068.0134335
VT
101YP2500X
Professional Counselor
03-997355
CT
Other
Enumeration date
08/21/2018
Last updated
04/01/2024
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