Jennifer Ivy Gordon, MSW
Individual provider Active NPI Clinical Social Worker · Montpelier, VT
NPI 1013097161 · NPPES record last updated Dec 9, 2013
Key facts
- NPI
- 1013097161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089-0000857 (VT)
- Practice address
- 156 Main St
Montpelier, VT 05602-2702 - Phone
- (802) 223-4738
- Fax
- (802) 223-6067
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089-0000857 | VT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0000857 | VT | Yes |
Addresses
Primary practice location
156 Main St
Montpelier, VT 05602-2702
Mailing address
PO Box 547
Central Vermont Medical Center - Finance Dept
Barre, VT 05641-0547
Phone (802) 223-4738
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1008603 | Medicaid | VT |
Other providers in Montpelier, VT
- Jeneve Michelle Girard-Dicarlo
- Kristin Glaser
- Elyse Gluck
- Hannah Goguen
- Good to You Nutrition
- M Corbin Gould
- Elizabeth Graham
- Rebecca-Lyn Rose Grant
- Stuart M Graves
- Green Dragon Medicine LLC
All providers in Montpelier, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.