Candie Killackey, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1017916 Issued in MA

Practice address

350 South Main Street
St. Albans, VT 05478

Phone

(802) 526-4438

NPI assigned

Sep 20, 2005

Last updated

Jan 24, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1225023856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11",
            "city": "FAIRFAX",
            "state": "VT",
            "postal_code": "054540011",
            "telephone_number": "978-526-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SOUTH MAIN STREET",
            "city": "ST. ALBANS",
            "state": "VT",
            "postal_code": "05478",
            "telephone_number": "802-526-4438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "563 Main St",
            "address_2": "Ste 8",
            "address_purpose": "LOCATION",
            "city": "Bolton",
            "state": "MA",
            "postal_code": "017401300",
            "country_code": "US",
            "telephone_number": "978-235-2686",
            "fax_number": "978-779-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLACKEY",
        "first_name": "CANDIE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1017916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "470068",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael T Kennedy, MD
• Anne Elizabeth Kenny, PT
• Sarah Kenny
• Rajvinder Khela, M.D.
• Jeanine Maniscalco Kichura, DPT
• Bridget L King, OT
• Casara J King
• Christopher Michael King
• Kevin J King
• Ian Kirkland

• Clinical Social Worker in Saint Albans, VT
• Providers in Saint Albans, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.