Provider Demographics
NPI:1922202266
Name:PALETTA, CAROLINE SIRAJ (MA LCMHC RDT)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:SIRAJ
Last Name:PALETTA
Suffix:
Gender:F
Credentials:MA LCMHC RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 POPPLE DUNGEON ROAD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05143-8931
Mailing Address - Country:US
Mailing Address - Phone:802-875-4592
Mailing Address - Fax:
Practice Address - Street 1:160 WALL STREET
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VT
Practice Address - Zip Code:05156-3528
Practice Address - Country:US
Practice Address - Phone:435-659-0761
Practice Address - Fax:802-885-1600
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680000275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1007755Medicaid
VT29525OtherBCBS OF VT