Provider Demographics
NPI:1912304296
Name:ACITO, ANNA ELIZABETH
Entity type:Individual
Prefix:
First Name:ANNA ELIZABETH
Middle Name:
Last Name:ACITO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANNA ELIZABETH
Other - Middle Name:ELIZABETH
Other - Last Name:MCFAUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:656 SUMMER STREET
Mailing Address - Street 2:
Mailing Address - City:ST. JOHNSBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05819
Mailing Address - Country:US
Mailing Address - Phone:800-785-4611
Mailing Address - Fax:877-785-4425
Practice Address - Street 1:1129 MAIN ST
Practice Address - Street 2:
Practice Address - City:ST JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819-2601
Practice Address - Country:US
Practice Address - Phone:800-785-4611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-02
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0090292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health