Charles David Gottlieb, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0000030 Issued in VT

Practice address

149 Cherry St
Burlington, VT 05401-3817

Phone

(802) 863-2495

Fax

(802) 865-0534

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Networks

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1952451650
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201564800000",
    "number": "1033280623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "473 NORTH ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011620",
            "telephone_number": "802-863-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 CHERRY ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013817",
            "telephone_number": "802-863-2495",
            "fax_number": "802-865-0534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTTLIEB",
        "first_name": "CHARLES",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2008-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006770",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany J Goss, LCMHC
• Jeanne Gosselin, M.D.
• Ann E Gotham, ANP
• Debra Lopez Gottesman, M.D.
• Krysta Gottfried
• Diane T Gottlieb, MSW, PH.D.
• Manoj Purna Goud
• Sarah J Goudreau, AUD
• Jonathan Gougelet, MD
• Daniel Goulette

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.