Provider Demographics
NPI:1962241083
Name:BLANCHARD, JENNIFER (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:VERGENNES
Mailing Address - State:VT
Mailing Address - Zip Code:05491-1346
Mailing Address - Country:US
Mailing Address - Phone:802-373-1281
Mailing Address - Fax:
Practice Address - Street 1:46 MAIN ST # 903
Practice Address - Street 2:
Practice Address - City:WINOOSKI
Practice Address - State:VT
Practice Address - Zip Code:05404-2242
Practice Address - Country:US
Practice Address - Phone:802-373-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0135901101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health