Provider Demographics
NPI:1619095114
Name:SLADYK-BENOIT, MARGARET R (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:R
Last Name:SLADYK-BENOIT
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LOCKE MILL LN
Mailing Address - Street 2:
Mailing Address - City:HYDE PARK
Mailing Address - State:VT
Mailing Address - Zip Code:05655-9677
Mailing Address - Country:US
Mailing Address - Phone:802-888-1572
Mailing Address - Fax:
Practice Address - Street 1:2 LOWER MAIN ST.
Practice Address - Street 2:
Practice Address - City:JOHNSON
Practice Address - State:VT
Practice Address - Zip Code:05656
Practice Address - Country:US
Practice Address - Phone:802-635-2007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00006541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1013161Medicaid