Provider Demographics
NPI:1912248337
Name:SHERMAN, KATHRYN L (LCMHC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:L
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:L
Other - Last Name:GARNEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 ELSOM PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-6606
Mailing Address - Country:US
Mailing Address - Phone:508-269-8744
Mailing Address - Fax:
Practice Address - Street 1:187 SAINT PAUL ST STE 101
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4689
Practice Address - Country:US
Practice Address - Phone:802-734-9153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068-0120264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1035885Medicaid