Provider Demographics
NPI:1912277534
Name:SLOANE, CHRISTOPHER MARK (MA, LCMHC, LADC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MARK
Last Name:SLOANE
Suffix:
Gender:M
Credentials:MA, LCMHC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 CREEK LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VT
Mailing Address - Zip Code:05477-9799
Mailing Address - Country:US
Mailing Address - Phone:802-881-1348
Mailing Address - Fax:
Practice Address - Street 1:31 PATCHEN RD
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-5705
Practice Address - Country:US
Practice Address - Phone:802-881-1348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-12
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0005003101YA0400X
VT068.0060333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)