Elliott Buelter, LICSW
Individual provider Active NPI Clinical Social Worker · Hyde Park, VT
NPI 1336685809 · NPPES record last updated Apr 27, 2021
Key facts
- NPI
- 1336685809
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089.0134300 (VT)
- Practice address
- 156 Johnson Street Ext
Hyde Park, VT 05655-9354 - Phone
- (802) 851-0301
- NPI assigned
- Jan 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089.0134300 | VT | MD | Clinical Social Worker |
Interoperability endpoints
- elliott.buelter@tabula-rasa-therapy-llc.direct.kno2fy.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089.0134300 | VT | Yes |
Addresses
Primary practice location
156 Johnson Street Ext
Hyde Park, VT 05655-9354
Mailing address
156 Johnson Street Ext
Hyde Park, VT 05655-9354
Phone (401) 714-4930
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6705170 | Medicaid | VT |
Other names
- Mr. Elliott Buelter
Other providers in Hyde Park, VT
- John S Aarts
- Kimberly D Austin Puleio
- Julie Lynne Bomengen
- Martin Brutus
- August Burns
- Clarks Residential Care Home LLC
- Lisa Dimondstein
- Rebecca Stuart Doherty
- Forest Hill Residential Care Home
All providers in Hyde Park, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 27, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.