IndividualActive
Amanda Koennicke, MA
NPI 1982573606 · Mental Health Counselor · Derby, VT
Provider details
- NPI number
- 1982573606
- Entity type
- Individual
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Credential
- MA
- Sex
- Female
- Sole proprietor
- Yes
- License
- 097.0133085 (VT)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
53 Cross Road
Derby, VT 05829
Phone: (802) 487-7801
Approximate (ZIP-level) locationGet directions
Mailing address
53 Cross Rd
Newport, VT 05855-8856
Registry dates
- Enumerated
- 2025-10-31
- Last updated
- 2025-10-31
- Certified
- 2025-10-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.