Individual provider Active NPI

Anna Mumford, LICSW

  • Clinical Social Worker
  • South Burlington, VT
National Provider Identifier
1124855671
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0132506 Issued in VT
Practice address
50 Joy Dr
South Burlington, VT 05403-6118
Phone
(802) 557-1939
Fax
(802) 861-6460
NPI assigned
Sep 18, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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 089.0132506 VT Primary

Addresses

Primary practice location

50 Joy Dr
South Burlington, VT 05403-6118

Mailing address

PO Box 4009
Burlington, VT 05406-4009
Phone (802) 557-1939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
089.0132506VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1124855671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4009",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054064009",
            "telephone_number": "802-557-1939",
            "fax_number": "802-488-3711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 JOY DR",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036118",
            "telephone_number": "802-557-1939",
            "fax_number": "802-861-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "ANNA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0132506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.