Demaris Tisdale, M.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0000231 Issued in VT

Practice address

69 Barre St
Montpelier, VT 05602-3504

Phone

(802) 229-2770

NPI assigned

Mar 27, 2007

Sex

Female

Sole proprietor

Yes

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in VT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043339773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SNIPE IRELAND RD",
            "city": "RICHMOND",
            "state": "VT",
            "postal_code": "054779691",
            "telephone_number": "802-434-3941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 BARRE ST",
            "city": "MONTPELIER",
            "state": "VT",
            "postal_code": "056023504",
            "telephone_number": "802-229-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TISDALE",
        "first_name": "DEMARIS",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0009816",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber R. Thomas, MS, CADC
• Heidi Louise Thompson, M.A.
• Ronald Edward Thompson, PSY MA
• Tamella K. Thygesen, AS
• Laura Timmkreitzer
• Jeniffer Tobon, ARNP
• Leslee G Tocci, LCMHC
• Gregory Tomasulo, PH.D.
• Jenjira M Townsend
• Treatment Associates, Inc

• All providers in Montpelier, VT
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.