Provider Demographics
NPI:1164305355
Name:DEZOTELL, KATHRYN (MSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DEZOTELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:DEZOTELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:390 RIVER STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VT
Mailing Address - Zip Code:05156
Mailing Address - Country:US
Mailing Address - Phone:802-886-4500
Mailing Address - Fax:802-886-4520
Practice Address - Street 1:132 S. MAIN STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001
Practice Address - Country:US
Practice Address - Phone:802-281-7080
Practice Address - Fax:802-281-7086
Is Sole Proprietor?:No
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional