Provider Demographics
NPI:1508580184
Name:BLAIS, JOSETTE (LCMHC)
Entity Type:Individual
Prefix:
First Name:JOSETTE
Middle Name:
Last Name:BLAIS
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 MURRAY HILL DR
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-4222
Mailing Address - Country:US
Mailing Address - Phone:802-522-3461
Mailing Address - Fax:
Practice Address - Street 1:100 E STATE ST STE 101
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3112
Practice Address - Country:US
Practice Address - Phone:802-522-3461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-28
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0134948101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health