Individual provider Active NPI

Carol G Bennett, LICSW

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1366566200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
89-133 Issued in VT
Practice address
156 College St
Suite 201
Burlington, VT 05401-8423
Phone
(802) 651-7671
Fax
(802) 860-0183
NPI assigned
Mar 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 89-133 VT Primary

Addresses

Primary practice location

156 College St
Suite 201
Burlington, VT 05401-8423

Mailing address

156 College St
Suite 201
Burlington, VT 05401-8423
Phone (802) 651-7671

Other identifiers 1

IdentifierTypeStateIssuer
89-133OtherVTLICSW

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
I20110201000234 VT Practitioner - Clinical Social Worker 6800075250 Practice locations: Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

156 College St
Burlington, VT 05401-8423
Phone (802) 651-7671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89-133VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1174089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366566200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 COLLEGE ST",
            "address_2": "SUITE 201",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018423",
            "telephone_number": "802-651-7671",
            "fax_number": "802-860-0183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 COLLEGE ST",
            "address_2": "SUITE 201",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054018423",
            "telephone_number": "802-651-7671",
            "fax_number": "802-860-0183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "CAROL",
        "middle_name": "G",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "89-133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "89-133",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.