Individual provider Active NPI

Karin L Shearer, LICSW

  • Clinical Social Worker
  • Williston, VT
National Provider Identifier
1215984018
Registry record updated Jun 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890000599 Issued in VT
Practice address
183 Talcott Rd
Suite 206
Williston, VT 05495-2089
Phone
(802) 876-1100
Fax
(802) 876-1101
NPI assigned
May 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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 0890000599 VT Primary

Addresses

Primary practice location

183 Talcott Rd
Suite 206
Williston, VT 05495-2089

Mailing address

183 Talcott Rd
Suite 206
Williston, VT 05495-2089
Phone (802) 876-1100

Other identifiers 1

IdentifierTypeStateIssuer
1007191MedicaidVT

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
I20040113000010 VT Practitioner - Clinical Social Worker 5193625325 Practice locations: Stowe, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

996 S Main St
Suite 2C
Stowe, VT 05672-5195
Phone (802) 917-2306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890000599VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370822400000",
    "number": "1215984018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 TALCOTT RD",
            "address_2": "SUITE 206",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054952089",
            "telephone_number": "802-876-1100",
            "fax_number": "802-876-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 TALCOTT RD",
            "address_2": "SUITE 206",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054952089",
            "telephone_number": "802-876-1100",
            "fax_number": "802-876-1101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEARER",
        "first_name": "KARIN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-27",
        "last_updated": "2013-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1007191",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

Verify at the official NPI Registry.