Provider Demographics
NPI:1356753529
Name:COLLIGAN LOWELL, KATHLEEN (LADC)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:COLLIGAN LOWELL
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:COLLIGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LADC
Mailing Address - Street 1:820 LEMON FAIR RD
Mailing Address - Street 2:
Mailing Address - City:WEYBRIDGE
Mailing Address - State:VT
Mailing Address - Zip Code:05753-9723
Mailing Address - Country:US
Mailing Address - Phone:518-435-5866
Mailing Address - Fax:
Practice Address - Street 1:170 MIDDLE RD N
Practice Address - Street 2:
Practice Address - City:MIDDLEBURY
Practice Address - State:VT
Practice Address - Zip Code:05753-8609
Practice Address - Country:US
Practice Address - Phone:518-435-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT151.0127103101YA0400X
VT000615101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)