Provider Demographics
NPI:1770355604
Name:DIAMOND, ELIZABETH M (LCMHC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:DIAMOND
Suffix:
Gender:
Credentials:LCMHC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:MCGINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05601-0647
Mailing Address - Country:US
Mailing Address - Phone:802-479-4083
Mailing Address - Fax:802-476-1476
Practice Address - Street 1:174 HOSPITAL LOOP
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9105
Practice Address - Country:US
Practice Address - Phone:802-479-4083
Practice Address - Fax:802-476-1476
Is Sole Proprietor?:No
Enumeration Date:2023-10-24
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT151.0134213101YA0400X
VT068.0135554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)