Provider Demographics
NPI:1831599885
Name:KARSTAD, JENNY V (LCMHC)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:V
Last Name:KARSTAD
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0101
Mailing Address - Country:US
Mailing Address - Phone:802-257-7785
Mailing Address - Fax:802-258-3723
Practice Address - Street 1:1 ANNA MARSH LANE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05302-0101
Practice Address - Country:US
Practice Address - Phone:802-257-7785
Practice Address - Fax:802-258-3723
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0057641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health