Theresa Chance Gleason, LICSW
Individual provider Active NPI Clinical Social Worker · Bridport, VT
NPI 1265619183 · NPPES record last updated Jan 22, 2008
Key facts
- NPI
- 1265619183
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089-0000196 (VT)
- Practice address
- 2076 East St
Bridport, VT 05734-9680 - Phone
- (802) 758-2476
- NPI assigned
- Jan 22, 2008
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089-0000196 | VT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0000196 | VT | Yes |
Addresses
Primary practice location
2076 East St
Bridport, VT 05734-9680
Mailing address
2076 East St
Bridport, VT 05734-9680
Phone (802) 758-2476
Other providers in Bridport, VT
- Judith A. Hancox
- Her Second Act Counseling Services PLLC
- Amber D Trudo
- Laurie Webb
- White Wolf Ministry
All providers in Bridport, 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 Jan 22, 2008. 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.