Individual provider Active NPI

Salissa Wahlers, LICSW

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1265815690
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0086150 Issued in VT
Practice address
128 Lakeside Ave
Ste 260
Burlington, VT 05401-4939
Phone
(802) 657-7000
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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 089.0086150 VT Primary

Addresses

Primary practice location

128 Lakeside Ave
Ste 260
Burlington, VT 05401-4939

Mailing address

128 Lakeside Ave
Ste 260
Burlington, VT 05401-4939
Phone (802) 657-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
089.0086150VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1265815690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "address_2": "STE 260",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939",
            "telephone_number": "802-657-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "address_2": "STE 260",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939",
            "telephone_number": "802-657-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLERS",
        "first_name": "SALISSA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0086150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.