Northeast Kingdom Human Services Inc
Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Newport, VT
NPI 1043372709 · NPPES record last updated Dec 4, 2025
Key facts
- NPI
- 1043372709
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
- Legal business name
- NORTHEAST KINGDOM HUMAN SERVICES INC
- Practice address
- 181 Crawford Rd
Newport, VT 05855-6405 - Phone
- (802) 334-6744
- Fax
- (802) 334-7455
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Denis Houle, MA
- Title
- Chief Financial Officer
- Phone
- (802) 334-6744
Corporate family (same tax ID) 16
Practitioners 44
-
John A Andrews, MS LADC
-
Dawn A Arenas, LICSW, LADC
-
Melanie Clarke, PMHNP
-
Patricia A Daly, MD
-
Shari Lee Ryan, LCMHC
-
Noreen Joy Shapiro-Berry, LCMHC
-
Nicole A Bristol, APRN, PMHNP-BC
-
Patricia Collins, LICSW
-
Jesse Roessler, LPC NCC
-
Andrea Seek, MD
-
Rachel Elizabeth De Amicis, MSW, LCSW, LICSW
-
Margaret Beadle, MA, LCMHC
-
Andre Jermaine Eason Jr., LADC, LCMHC
-
Lisa Erwin, L.I.C.S.W.
-
Deidre Flanders, LICSW, LADC
-
Kelly Hensley, DNP, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041012001355 | VT | Part B Supplier - Clinic/Group Practice | 0941276703 |
Receives reassigned benefits from 43 practitioners Practice locations: Derby, VT; Saint Johnsbury, VT |
National Provider Directory
- Tax ID family
- Northeast Kingdom Human Services Inc
Locations
172 Bogner Dr
Newport, VT 05855
Phone (802) 334-5247
2225 Portland St
St Johnsbury, VT 05819
Phone (802) 748-3181
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | |||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Yes | ||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
181 Crawford Rd
Newport, VT 05855-6405
Mailing address
PO Box 724
Newport, VT 05855-0724
Phone (802) 334-6744
Other practice location 1
2225 Portland St
St Johnsbury, VT 05819-8635
Phone (802) 748-0215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1009784 | Medicaid | VT | |
| 0006073 | Medicaid | VT |
Other providers in Newport, VT
- Northeast Kingdom Hematology Oncology PLLC
- Northeast Kingdom Hematology Oncology PLLC
- Northeast Kingdom Homecare, Inc.
- Northeast Kingdom Homecare, Inc.
- Northeast Kingdom Homecare, Inc.
- Northeast Kingdom Human Services Inc Accs
- Northeast Kingdom Human Services Inc CRT
- Northeast Kingdom Human Services Inc Csub
- Northeast Kingdom Human Services Inc DS
- Northeast Kingdom Human Services Inc DS Waiver
All providers in Newport, VT · Mental Health Clinic/Center (Including Community Mental Health Center) in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 4, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.