Evan T Smith, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089.0060670 Issued in VT

Practice address

130 Fisher Rd Unit 1
Berlin, VT 05602-8132

Phone

(802) 371-4100

NPI assigned

Dec 14, 2021

Last updated

Dec 14, 2021By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Central Vermont Medical Center Inc

  • Family Medicine Physician
  • Berlin, VT
  • NPI 1023028784
  NPD
• Central Vermont Cardiology Associates Inc.

  • Interventional Cardiology Physician
  • Berlin, VT
  • NPI 1114946399
  NPD (past)

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1285393645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056410547",
            "telephone_number": "802-371-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 FISHER RD UNIT 1",
            "city": "BERLIN",
            "state": "VT",
            "postal_code": "056028132",
            "telephone_number": "802-371-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EVAN",
        "middle_name": "T",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0060670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devika Singh, M.D.
• Priyanka Singh, M.D.
• Sarah Sliva, MD
• Scott Alan Small, PA-C
• Craig Smith, LADC, LICSW
• Bonnie Solley, BSN, IBCLC
• Matthew D. Sowers, PHARMD
• Laurie Spaulding, MD
• Leah K St. Martin, PA-C
• Dale D Stafford, M.D.

• Clinical Social Worker in Berlin, VT
• Providers in Berlin, 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 Dec 14, 2021; 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.