Active NPI
Jennifer N Spagnuolo, LCMHC
- Mental Health Counselor
- Essex Junction, VT
National Provider Identifier
1346440435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 068-0000710
- Practice address
- 21 Warner Ave
Essex Junction, VT 05452-3018 - Phone
- (802) 557-0303
- NPI assigned
- Jul 18, 2007
- Last updated
- Dec 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 068-0000710 | VT | Primary |
Addresses
Primary practice location
21 Warner Ave
Essex Junction, VT 05452-3018
Mailing address
21 Warner Ave
Essex Junction, VT 05452-3018
Phone (802) 557-0303
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 22, 2024 through Jan 22, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068-0000710 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184716800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1346440435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WARNER AVE",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054523018",
"telephone_number": "802-557-0303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 WARNER AVE",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054523018",
"telephone_number": "802-557-0303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPAGNUOLO",
"first_name": "JENNIFER",
"middle_name": "N",
"credential": "LCMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-18",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068-0000710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.