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Individual

MR. RYAN TIMOTHY STANTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW, LADC

Contact information

Practice address
132 MAIN ST, MONTPELIER, VT 05602
(802) 489-6710
Mailing address
168 NORTHFIELD ST, MONTPELIER, VT 05602-3333
(802) 249-7260

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151.0124675
VT
1041C0700X
Clinical Social Worker
Primary
089.0084653
VT

Other

Enumeration date
05/22/2018
Last updated
11/15/2018
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