Judith C Daly, LICSW

Individual provider Active NPI Clinical Social Worker · Williston, VT

NPI 1295085546 · NPPES record last updated Sep 13, 2012

Key facts

NPI
1295085546
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
089.0000186 (VT)
Practice address
277 Blair Park Rd Ste 210
Williston, VT 05495-7885
Phone
(802) 338-7377
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20130130000357 VT Practitioner - Clinical Social Worker 8921252834 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
089.0000186VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Judi Daly, Licsw PLLC Clinical Current
since Dec 23, 2012
Accepting new patients

Locations

525 Hercules Dr
Ste 1A
Colchester, VT 05446
Phone (802) 264-5333

277 Blair Park Rd
Ste 210
Williston, VT 05495
Phone (802) 264-5333

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0000186 VT Yes

Addresses

Primary practice location

277 Blair Park Rd Ste 210
Williston, VT 05495-7885

Mailing address

PO Box 731
Waterbury, VT 05676-0731
Phone (802) 338-7377

Other providers in Williston, VT

All providers in Williston, VT · Clinical Social Worker in Vermont

Sources for this page

Verify at the official NPI Registry.