Individual provider Active NPI

Kathleen C McIsaac, MA. CMHC

  • Mental Health Counselor
  • Bradford, VT
National Provider Identifier
1619644366
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
068.0134997 Issued in VT
Practice address
1084 Fairground Rd
Bradford, VT 05033-9318
Phone
(802) 323-6172
NPI assigned
Aug 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1527 NH
Addiction (Substance Use Disorder) Counselor 101YA0400X 151.0134176 VT
Addiction (Substance Use Disorder) Counselor 101YA0400X LC8976 ME
Mental Health Counselor 101YM0800X 4724 NH
Mental Health Counselor 101YM0800X 068.0134997 VT Primary

Addresses

Primary practice location

1084 Fairground Rd
Bradford, VT 05033-9318

Mailing address

1084 Fairground Rd
Bradford, VT 05033-9318
Phone (802) 323-6172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LC8976MEMDAddiction (Substance Use Disorder) Counselor
151.0134176VTMDAddiction (Substance Use Disorder) Counselor
068.0134997VTMDMental Health Counselor
4724NHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ctr Therapy LLC CurrentSince Mar 5, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1619644366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 FAIRGROUND RD",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050339318",
            "telephone_number": "802-323-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1084 FAIRGROUND RD",
            "city": "BRADFORD",
            "state": "VT",
            "postal_code": "050339318",
            "telephone_number": "802-323-6172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCISAAC",
        "first_name": "KATHLEEN",
        "middle_name": "C",
        "credential": "MA. CMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "1527",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "151.0134176",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC8976",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NH",
            "license": "4724",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0134997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradford, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.