Individual provider Active NPI

David Huesman, LICSW LADC

  • Clinical Social Worker
  • South Burlington, VT
National Provider Identifier
1073784849
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890000376 Issued in VT
Practice address
34 Patchen Rd
South Burlington, VT 05403-5704
Phone
(802) 658-4208
Fax
(802) 658-2234
NPI assigned
Mar 19, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0890000376 VT Primary

Addresses

Primary practice location

34 Patchen Rd
South Burlington, VT 05403-5704

Mailing address

34 Patchen Rd
South Burlington, VT 05403-5704
Phone (802) 658-4208

Other identifiers 1

IdentifierTypeStateIssuer
OVN0958MedicaidVT

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060403000163 VT Practitioner - Clinical Social Worker 5991713950 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2 Church St
Suite 3H
Burlington, VT 05401-4457
Phone (802) 760-8389

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890000376VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
David Huesman Inc Clinical CurrentSince Oct 1, 2007 Accepting new patients
Tage Lilja Licsw PLC Clinical PastSince Oct 1, 2007 Accepting new patients

Locations

2 Church St
Ste 3H
Burlington, VT 05401
Phone (802) 391-9865

34 Patchen Rd
South Burlington, VT 05403
Phone (802) 658-4208

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205884800000",
    "number": "1073784849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PATCHEN RD",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054035704",
            "telephone_number": "802-658-4208",
            "fax_number": "802-658-2234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PATCHEN RD",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054035704",
            "telephone_number": "802-658-4208",
            "fax_number": "802-658-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUESMAN",
        "first_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LICSW LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN0958",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.