Katelyn Michelle Dearth, LICSW, AAP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0134203 Issued in VT

Practice address

1233 Shelburne Rd Ste D2
South Burlington, VT 05403-7753

Phone

(802) 859-1577

Fax

(802) 859-1571

NPI assigned

Jun 21, 2019

Last updated

Nov 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1561075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1093376097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 SHELBURNE RD STE D2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037753",
            "telephone_number": "802-859-1577",
            "fax_number": "802-859-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 SHELBURNE RD STE D2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037753",
            "telephone_number": "802-859-1577",
            "fax_number": "802-859-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARTH",
        "first_name": "KATELYN",
        "middle_name": "MICHELLE",
        "credential": "LICSW, AAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-21",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0134203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in South Burlington, VT
• Providers in South Burlington, 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 Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.