Individual provider Active NPI

Lucas Kovacevich

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1154255230
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0137153 Issued in VT
Practice address
1 S Prospect St
Burlington, VT 05401-3456
Phone
(802) 847-9788
NPI assigned
Jun 11, 2026
Last updated
Jun 15, 2026By the provider in NPPES
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 089.0137153 VT
Clinical Social Worker 1041C0700X 089.0137153 VT Primary

Addresses

Primary practice location

1 S Prospect St
Burlington, VT 05401-3456

Mailing address

1 S Prospect St
Burlington, VT 05401-5505
Phone (802) 847-4589

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
I20260623001377 VT Practitioner - Clinical Social Worker 4284107194

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Vermont College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Vermont Medical Center IncGroup PAC ID 3779491071, shared by 13 NPIs, 1,208 clinicians

Practice addresses (Care Compare)

111 Colchester Ave
Burlington, VT 05401-1473
Phone (802) 847-0000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1154255230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015505",
            "telephone_number": "802-847-4589",
            "fax_number": "802-847-2461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S PROSPECT ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054013456",
            "telephone_number": "802-847-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVACEVICH",
        "first_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2026-06-11",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "VT",
            "license": "089.0137153",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0137153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.