Mary Ann Dattilo Boyd, LICSW
Individual provider Active NPI Clinical Social Worker · Middlebury, VT
NPI 1104903319 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104903319
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0890001058 (VT)
- Practice address
- 135 S Pleasant St
Middlebury, VT 05753-1479 - Phone
- (802) 349-6182
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0890001058 | VT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mary Ann Dattilo Boyd PLLC | Clinical | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0890001058 | VT | Yes |
Addresses
Primary practice location
135 S Pleasant St
Middlebury, VT 05753-1479
Mailing address
459 Lower Notch Rd
Bristol, VT 05443-5210
Phone (802) 349-6182
Other providers in Middlebury, VT
- Jacqueline M Botala
- Justin P Bouchard
- Charles Raymond Bowen
- Scott Martin Bowen
- Philip B. Bowman
- Johana Kashiwa Brakeley
- Willis Breen
- Kayla Brenden
- Mary Louise Brevda
- Angela Marie Brisson
All providers in Middlebury, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.