Provider Demographics
NPI:1578069043
Name:WEIN-SENGHAS, ALICIA ANNE MARIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:ANNE MARIE
Last Name:WEIN-SENGHAS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 PARK ST
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-9098
Mailing Address - Country:US
Mailing Address - Phone:802-793-8076
Mailing Address - Fax:
Practice Address - Street 1:200 PARK ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-9098
Practice Address - Country:US
Practice Address - Phone:802-793-8076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0122646101YM0800X
VT048.0134738103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty