Provider Demographics
NPI:1578328134
Name:LUZARDO, NGOC (MS CMHC, HHP)
Entity Type:Individual
Prefix:MRS
First Name:NGOC
Middle Name:
Last Name:LUZARDO
Suffix:
Gender:F
Credentials:MS CMHC, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05036-9762
Mailing Address - Country:US
Mailing Address - Phone:802-565-7591
Mailing Address - Fax:
Practice Address - Street 1:103 S MAIN ST STE 6
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4839
Practice Address - Country:US
Practice Address - Phone:802-505-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT097.0136063101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health