Provider Demographics
NPI:1477977866
Name:MATCHETTE, ABIGAIL (LICSW)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:MATCHETTE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002A ETHAN ALLEN AVE
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:VT
Mailing Address - Zip Code:05452-4014
Mailing Address - Country:US
Mailing Address - Phone:802-304-0703
Mailing Address - Fax:
Practice Address - Street 1:1002A ETHAN ALLEN AVE
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-4014
Practice Address - Country:US
Practice Address - Phone:802-304-0703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-06
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00933501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical