Provider Demographics
NPI:1477033207
Name:ESANCY, JACQUELINE F (LADC, LCMHC, LPC)
Entity Type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:F
Last Name:ESANCY
Suffix:
Gender:F
Credentials:LADC, LCMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WILSON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VT
Mailing Address - Zip Code:05454-4409
Mailing Address - Country:US
Mailing Address - Phone:802-255-8801
Mailing Address - Fax:802-491-8230
Practice Address - Street 1:30 WILSON RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VT
Practice Address - Zip Code:05454-4409
Practice Address - Country:US
Practice Address - Phone:802-255-8801
Practice Address - Fax:802-491-8230
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03-997355101YP2500X
VT068.0134335101YM0800X
VT151-0134045101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)