Grace Becker Wilson, LIC SW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0890000712 Issued in VT

Practice address

160 Benmont Ave
Bennington, VT 05201-1873

Phone

(802) 379-4548

NPI assigned

Feb 26, 2007

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332115200000",
    "number": "1083740815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537",
            "city": "N BENNINGTON",
            "state": "VT",
            "postal_code": "052570537",
            "telephone_number": "802-379-4548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 BENMONT AVE",
            "city": "BENNINGTON",
            "state": "VT",
            "postal_code": "052011873",
            "telephone_number": "802-379-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "GRACE",
        "middle_name": "BECKER",
        "name_prefix": "Ms.",
        "credential": "LIC SW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2012-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OVN1867",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monica L Wielt, LICSW
• Justin Carl Wilkinson, ATS
• Suzanne Willard
• William J Sarchino, DPM
• Courtnay Wilson, PSYD
• Gregory Wilson, PHARMD
• Sarah Handley Winchester, LICSW
• Angela Wingate, MD
• Richard A Wiseman, MD
• Rachel E. Wolgemuth, PT

• Clinical Social Worker in Bennington, VT
• Providers in Bennington, 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 Mar 19, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.