Sudhir Shantinath, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0000839 Issued in VT

Practice address

56 W Twin Oaks Ter
South Burlington, VT 05403-7106

Phone

(802) 847-3333

Fax

(802) 847-1424

NPI assigned

Aug 23, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anodyne Cognitive Therapy, PLLC

  • Clinical Social Worker
  • Burlington, VT
  • NPI 1326744541
  NPD Authorized official

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235246661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HIGH GROVE CT",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011644",
            "telephone_number": "802-864-4698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 W TWIN OAKS TER",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037106",
            "telephone_number": "802-847-3333",
            "fax_number": "802-847-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANTINATH",
        "first_name": "SUDHIR",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0VN2614",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher John Sernaque, EDD, RP
• Jillian Seymour
• Susan D Shaffer, LCMHC
• Palak Viren Shah, DPT
• Mary Kate Shanahan
• Ari Shapiro-Miller
• Irene F. Sharp, M.A.
• Anthony Orr Shaw, PT
• Krista Shea, MS, CCC-SLP
• Jamie Sheahan, M.S., R.D.

• Clinical Social Worker in South Burlington, VT
• Providers in South Burlington, 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 Jul 8, 2007; 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.