Provider Demographics
NPI:1295565372
Name:DARA STIMSON, LICSW, LLC
Entity type:Organization
Organization Name:DARA STIMSON, LICSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:STIMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:802-233-7213
Mailing Address - Street 1:PO BOX 8142
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:VT
Mailing Address - Zip Code:05451-8142
Mailing Address - Country:US
Mailing Address - Phone:802-233-7213
Mailing Address - Fax:
Practice Address - Street 1:20 SOUTHDOWN CT
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-3053
Practice Address - Country:US
Practice Address - Phone:802-233-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty