Basic Information
| Provider Information | |||||||||
| NPI: | 1316387103 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MCARTOR | ||||||||
| FirstName: | WADE | ||||||||
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| Credential: | LADC,LCMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 208 FLYNN AVE | ||||||||
| Address2: | 3J | ||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024886920 | ||||||||
| FaxNumber: | 8024886919 | ||||||||
| Practice Location | |||||||||
| Address1: | 172 FAIRFIELD ST | ||||||||
| Address2: | |||||||||
| City: | SAINT ALBANS | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054781743 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8024886265 | ||||||||
| FaxNumber: | 8024886919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2013 | ||||||||
| LastUpdateDate: | 10/14/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 000569 | VT | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | 068-0079849 | VT | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.