Provider Demographics
NPI:1972830123
Name:VANZANDT, ELENA MICHELLE SUTFIN (MED, MLADC, CPS, SAP)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:MICHELLE SUTFIN
Last Name:VANZANDT
Suffix:
Gender:F
Credentials:MED, MLADC, CPS, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:CANAAN
Mailing Address - State:NH
Mailing Address - Zip Code:03741-7644
Mailing Address - Country:US
Mailing Address - Phone:603-523-8804
Mailing Address - Fax:603-523-8804
Practice Address - Street 1:44 ROBERTS ROAD
Practice Address - Street 2:
Practice Address - City:CANAAN
Practice Address - State:NH
Practice Address - Zip Code:03741
Practice Address - Country:US
Practice Address - Phone:603-359-3321
Practice Address - Fax:603-523-8804
Is Sole Proprietor?:No
Enumeration Date:2009-11-09
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHMED#0608101Y00000X
LADC#0608101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor