Active NPI
Corrine Mertz, LICSW
- Clinical Social Worker
- South Burlington, VT
National Provider Identifier
1326498031
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 089-0114732
- Practice address
- 1025 Airport Dr
South Burlington, VT 05403-6013 - Phone
- (802) 488-7711
- Fax
- (802) 488-6919
- NPI assigned
- Jun 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0114732 | VT | Primary |
Addresses
Primary practice location
1025 Airport Dr
South Burlington, VT 05403-6013
Mailing address
208 Flynn Ave
Suite 3J
Burlington, VT 05401-5429
Phone (802) 488-6920
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089-0114732 | VT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465862400000",
"number": "1326498031",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "208 FLYNN AVE",
"address_2": "SUITE 3J",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015429",
"telephone_number": "802-488-6920",
"fax_number": "802-488-6919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1025 AIRPORT DR",
"city": "SOUTH BURLINGTON",
"state": "VT",
"postal_code": "054036013",
"telephone_number": "802-488-7711",
"fax_number": "802-488-6919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERTZ",
"first_name": "CORRINE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2016-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VT",
"license": "089-0114732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.