Individual provider Active NPI

Gillian Lee Skovron, LICSW

  • Clinical Social Worker
  • Waterbury, VT
National Provider Identifier
1144355025
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890000938 Issued in VT
Practice address
89 South Main Street
Waterbury, VT 05676
Phone
(802) 498-4978
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0890000938 VT Primary

Addresses

Primary practice location

89 South Main Street
Waterbury, VT 05676

Mailing address

89 South Main Street
Waterbury, VT 05676
Phone (802) 498-4978

Other identifiers 1

IdentifierTypeStateIssuer
1009472MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110209000253 VT Practitioner - Clinical Social Worker 4981884913 Practice locations: Waterbury, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Vermont College of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Waterbury, VT 05676
Phone (802) 498-4978

89 S Main St
Suite 2
Waterbury, VT 05676-1578
Phone (802) 498-4978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890000938VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144355025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 SOUTH MAIN STREET",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "05676",
            "telephone_number": "802-498-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SOUTH MAIN STREET",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "05676",
            "telephone_number": "802-498-4978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOVRON",
        "first_name": "GILLIAN",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1009472",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, VT

Sources for this page

Verify at the official NPI Registry.