Individual provider Active NPI

Kristyn D Harrington, LICSW, LADC

  • Clinical Social Worker
  • Manchester Center, VT
National Provider Identifier
1265925770
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0000709 Issued in VT
Practice address
5188 Main St
Manchester Center, VT 05255-9783
Phone
(802) 367-3165
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 151.0127406 VT
Clinical Social Worker 1041C0700X 089.0000709 VT Primary

Addresses

Primary practice location

5188 Main St
Manchester Center, VT 05255-9783

Mailing address

PO Box 2444
Manchester Center, VT 05255-2444
Phone (802) 367-3165

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251126003089 VT Practitioner - Clinical Social Worker 5294113767 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5188 Main St
Manchester Center, VT 05255-9783
Phone (802) 367-3165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
151.0127406VTMDAddiction (Substance Use Disorder) Counselor
089.0000709VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KDH Counseling PLLC Addiction (Substance Use Disorder) CurrentSince May 14, 2018 Accepting new patients

Locations

5188 Main St
Manchester Center, VT 05255
Phone (802) 353-6590

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Southwestern Vermont Medical Center, IncBennington, VT, CCN 470012 Hospital Corporate Director May 1, 2022
Southwestern Vermont Medical Center, IncBennington, VT, CCN 47U012 Hospital Corporate Director May 1, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1265925770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2444",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052552444",
            "telephone_number": "802-367-3165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5188 MAIN ST",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052559783",
            "telephone_number": "802-367-3165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRINGTON",
        "first_name": "KRISTYN",
        "middle_name": "D",
        "credential": "LICSW, LADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "151.0127406",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0000709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester Center, VT

Sources for this page

Verify at the official NPI Registry.