Provider Demographics
NPI:1982989661
Name:DANZ, BLAIR (LPC,LCMHC,SUPERVISOR)
Entity type:Individual
Prefix:
First Name:BLAIR
Middle Name:
Last Name:DANZ
Suffix:
Gender:
Credentials:LPC,LCMHC,SUPERVISOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156-2935
Mailing Address - Country:US
Mailing Address - Phone:802-373-4584
Mailing Address - Fax:802-341-6568
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-2935
Practice Address - Country:US
Practice Address - Phone:802-373-4584
Practice Address - Fax:802-341-6568
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67393101Y00000X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional