Active NPI
Ann Gannon
- Mental Health Counselor
- Waterbury, VT
National Provider Identifier
1043759046
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 089.0114055
- Practice address
- 567 S Pinnacle Ridge Rd
Waterbury, VT 05676-9623 - Phone
- (802) 498-7979
- NPI assigned
- Feb 23, 2017
- Last updated
- Feb 23, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 089.0114055 | VT | Primary |
Addresses
Primary practice location
567 S Pinnacle Ridge Rd
Waterbury, VT 05676-9623
Mailing address
132 Main St
Montpelier, VT 05602-3226
Phone (802) 498-7979
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170309002086 | VT | Practitioner - Clinical Social Worker | 7012291107 | Practice locations: Montpelier, VT |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Washington University School of Medicine, 1993
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
132 Main St
Montpelier, VT 05602-3226
Phone (802) 498-7979
567 S Pinnacle Ridge Rd
Waterbury, VT 05676-9623
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089.0114055 | VT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487808000000",
"number": "1043759046",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 MAIN ST",
"city": "MONTPELIER",
"state": "VT",
"postal_code": "056023226",
"telephone_number": "802-498-7979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "567 S PINNACLE RIDGE RD",
"city": "WATERBURY",
"state": "VT",
"postal_code": "056769623",
"telephone_number": "802-498-7979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANNON",
"first_name": "ANN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-23",
"last_updated": "2017-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "089.0114055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; 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.