Individual
SHAWN M WALDRON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCMHC, LADC, NCC
Contact information
Practice address
45 CENTER ST, SUTTON, VT 05867-9705
(802) 745-9567
(802) 533-2044
Mailing address
45 CENTER ST, SUTTON, VT 05867-9705
(802) 745-9567
(802) 533-2044
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000644
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151.0127299
VT
101YM0800X
Mental Health Counselor
0680069442
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1022126
—
VT
05
—
31014778
—
NH
Enumeration date
08/16/2013
Last updated
11/29/2022
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