Kathleen M Costello, LICSW

Individual provider Active NPI Clinical Social Worker · Saint Albans, VT

NPI 1013408988 · NPPES record last updated May 25, 2018

Key facts

NPI
1013408988
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
089.0000941 (VT)
Practice address
12 Fairfield Hill Rd
Saint Albans, VT 05478-9634
Phone
(802) 524-1700
Fax
(802) 524-1777
NPI assigned
May 25, 2018
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
089.0000941VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nfi Vermont, Inc Past
since Jan 9, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0000941 VT Yes

Addresses

Primary practice location

12 Fairfield Hill Rd
Saint Albans, VT 05478-9634

Mailing address

30 Airport Rd
S Burlington, VT 05403-6432
Phone (802) 658-0040

Other providers in Saint Albans, VT

All providers in Saint Albans, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.