Individual provider Active NPI

Judith C Daly, LICSW

  • Clinical Social Worker
  • Williston, VT
National Provider Identifier
1295085546
Registry record updated Sep 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0000186 Issued in VT
Practice address
277 Blair Park Rd Ste 210
Williston, VT 05495-7885
Phone
(802) 338-7377
NPI assigned
Sep 13, 2012
Last updated
Sep 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2012

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 089.0000186 VT Primary

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

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
I20130130000357 VT Practitioner - Clinical Social Worker 8921252834 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Judi Daly, Licsw PLLC Clinical CurrentSince 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347494400000",
    "number": "1295085546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 731",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056760731",
            "telephone_number": "802-338-7377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 BLAIR PARK RD STE 210",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054957885",
            "telephone_number": "802-338-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "JUDITH",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2012-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0000186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

Verify at the official NPI Registry.