Individual provider Active NPI

Jason Amerosa, LICSW

  • Clinical Social Worker
  • South Burlington, VT
National Provider Identifier
1144063405
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0135607 Issued in VT
Practice address
1809 Spear St
South Burlington, VT 05403-7911
Phone
(802) 318-8432
NPI assigned
Jun 14, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 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 089-0135607 VT Primary

Addresses

Primary practice location

1809 Spear St
South Burlington, VT 05403-7911

Mailing address

208 Flynn Ave Ste 3J
Burlington, VT 05401-5420
Phone (802) 488-6920

Other practice location 1

1138 Pine St
Burlington, VT 05401-5353
Phone (802) 488-6000

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0135607VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1144063405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 FLYNN AVE STE 3J",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015420",
            "telephone_number": "802-488-6920",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 SPEAR ST",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037911",
            "telephone_number": "802-318-8432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1138 Pine St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054015353",
            "country_code": "US",
            "telephone_number": "802-488-6000",
            "fax_number": "802-488-6919",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMEROSA",
        "first_name": "JASON",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0135607",
            "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 Jul 25, 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.