Provider Demographics
NPI:1780484378
Name:FEREDAY-PARENT, ANGELA SUE (MA)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:FEREDAY-PARENT
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 ROOSEVELT HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-7896
Mailing Address - Country:US
Mailing Address - Phone:802-397-9525
Mailing Address - Fax:
Practice Address - Street 1:3619 ROOSEVELT HWY STE 1
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-7896
Practice Address - Country:US
Practice Address - Phone:802-397-9525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty