Provider Demographics
NPI:1497228506
Name:WEBSTER, MARCIA (LCMHC, CPS, SEP)
Entity Type:Individual
Prefix:
First Name:MARCIA
Middle Name:
Last Name:WEBSTER
Suffix:
Gender:F
Credentials:LCMHC, CPS, SEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4039 FAYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:VT
Mailing Address - Zip Code:05065-6566
Mailing Address - Country:US
Mailing Address - Phone:413-626-6968
Mailing Address - Fax:
Practice Address - Street 1:18 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-7062
Practice Address - Country:US
Practice Address - Phone:413-626-6968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0116831101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health