Provider Demographics
NPI:1649005083
Name:DEBARBIERI, JENNIFER (LADC, LCMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:DEBARBIERI
Suffix:
Gender:F
Credentials:LADC, LCMHC
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:DEBARBIERI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:125 KENNEDY DR APT 13
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7289
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:125 KENNEDY DR APT 13
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7289
Practice Address - Country:US
Practice Address - Phone:917-836-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-05
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT151.0134173101YA0400X
VT068.0136367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)