Provider Demographics
NPI:1467287490
Name:STAAB, ABIGAIL (LICSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:STAAB
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 MAIN RD APT 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-8826
Mailing Address - Country:US
Mailing Address - Phone:802-522-7835
Mailing Address - Fax:
Practice Address - Street 1:444 S UNION ST # C7
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4859
Practice Address - Country:US
Practice Address - Phone:802-522-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.01361041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical