Mystic Horizons, LLC

NPI #1225706195 in Hinesburg, Vermont

Provider Information

NPI Number: 1225706195
Entity Type: Organization
Organization Name: Mystic Horizons, LLC
Primary Specialty: Social Worker - Clinical
Enumeration Date: Sep 3, 2021
Last Updated: Sep 3, 2021

Practice Location

Address: 4995 SILVER ST
City: Hinesburg
State: Vermont
ZIP Code: 05461-9487
Phone: (802) 734-5864

Authorized Official

Name: ASHLEY MARIE MCCULLOUGH, LICSW
Title: LICENSED CLINICAL SOCIAL WORKER
Phone: (802) 734-5864

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X	Primary

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