Provider Demographics
NPI:1790527810
Name:SUTTON, JACEE S (LCMHC, LPC-MH, NCC,)
Entity type:Individual
Prefix:
First Name:JACEE
Middle Name:S
Last Name:SUTTON
Suffix:
Gender:F
Credentials:LCMHC, LPC-MH, NCC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 TANGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:VT
Mailing Address - Zip Code:05478-5144
Mailing Address - Country:US
Mailing Address - Phone:802-309-4878
Mailing Address - Fax:
Practice Address - Street 1:24 TANGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:VT
Practice Address - Zip Code:05478-5144
Practice Address - Country:US
Practice Address - Phone:802-309-4878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0110819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health