Individual provider Active NPI

Valerie Anne Koropatnick, LICSW

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1316093586
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0000115 Issued in VT
Practice address
300 Flynn Ave
Burlington, VT 05401-5301
Phone
(802) 488-6300
NPI assigned
Jan 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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 089-0000115 VT Primary

Addresses

Primary practice location

300 Flynn Ave
Burlington, VT 05401-5301

Mailing address

208 Flynn Ave
3J
Burlington, VT 05401-5429

Other identifiers 1

IdentifierTypeStateIssuer
1013830MedicaidVT

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305158400000",
    "number": "1316093586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 FLYNN AVE",
            "address_2": "3J",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FLYNN AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015301",
            "telephone_number": "802-488-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOROPATNICK",
        "first_name": "VALERIE",
        "middle_name": "ANNE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-28",
        "last_updated": "2011-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013830",
            "state": "VT"
        }
    ],
    "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 May 12, 2011; 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.