Taylor Zak, LICSW
Individual provider Active NPI Clinical Social Worker · Vergennes, VT
NPI 1235511486 · NPPES record last updated Oct 10, 2023
Key facts
- NPI
- 1235511486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089.0134221 (VT)
- Practice address
- 243 Commodore Dr
Vergennes, VT 05491-7506 - Phone
- (802) 999-2912
- NPI assigned
- Jun 24, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC15448 | ME | MD | Clinical Social Worker |
| 089.0134221 | VT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | MC15448 | ME | |
| Clinical Social Worker | 1041C0700X | 089.0134221 | VT | Yes |
Addresses
Primary practice location
243 Commodore Dr
Vergennes, VT 05491-7506
Mailing address
243 Commodore Dr
Vergennes, VT 05491-7506
Phone (802) 999-2912
Other providers in Vergennes, VT
All providers in Vergennes, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.