Provider Demographics
NPI:1164013470
Name:VERMILYEA, JEREMY J (LCMHC, LCPC, LADC)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:J
Last Name:VERMILYEA
Suffix:
Gender:M
Credentials:LCMHC, LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 SANDHILL RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VT
Mailing Address - Zip Code:05454-9564
Mailing Address - Country:US
Mailing Address - Phone:802-277-0317
Mailing Address - Fax:
Practice Address - Street 1:38 SANDHILL RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VT
Practice Address - Zip Code:05454-9564
Practice Address - Country:US
Practice Address - Phone:802-277-0317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-29
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC7047101YA0400X
MEXL5231101YM0800X
VT068.0135309101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)