Caleb John Shepherd, LICSW

Individual provider Active NPI Clinical Social Worker · Norwich, VT

NPI 1043377070 · NPPES record last updated Jan 12, 2023

Key facts

NPI
1043377070
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
0890001177 (VT)
Practice address
320 Main St # 3a
Norwich, VT 05055-4418
Phone
(802) 778-0941
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

320 Main St
3A
Norwich, VT 05055-4418
Phone (802) 778-0941

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150929002358 VT Practitioner - Clinical Social Worker 8123336898 Practice locations: Norwich, VT

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0890001177 VT Yes

Addresses

Primary practice location

320 Main St # 3a
Norwich, VT 05055-4418

Mailing address

465 New Boston Rd
Norwich, VT 05055-9681
Phone (802) 778-0941

Other practice location 1

32 Pleasant St
Woodstock, VT 05091-1122
Phone (802) 778-0941

Other identifiers

IdentifierTypeStateIssuer
089-0001177OtherVTLICSW
110290OtherMALICSW

Other providers in Norwich, VT

All providers in Norwich, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.