Stephen R Longley, LCSW
Individual provider Active NPI Clinical Social Worker · Dorset, VT
NPI 1417628686 · NPPES record last updated Jul 16, 2024
Key facts
- NPI
- 1417628686
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089.0135756 (VT)
- Practice address
- 143 Church St
Dorset, VT 05251-2001 - Phone
- (802) 445-5703
- NPI assigned
- Sep 27, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2021
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
143 Church St
Dorset, VT 05251-2001
Phone (802) 445-5703
PO Box
Suite 56
Dorset, VT 05251-0056
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240410000267 | VT | Practitioner - Clinical Social Worker | 1153769112 |
Reassigns benefits to 1 organization Practice locations: Dorset, VT |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jackson Peak Counseling, PLLC | Clinical | Current |
Accepting new patients |
| United Counseling Service of Bennington County, Inc. | Current |
Accepting new patients |
Locations
100 Ledgehill Rd
Bennington, VT 05201
Phone (802) 445-7300
3624 Main St
Ste 104
Manchester, VT 05254
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089.0135756 | VT | Yes |
Addresses
Primary practice location
143 Church St
Dorset, VT 05251-2001
Mailing address
PO Box 56
Dorset, VT 05251-0056
Phone (802) 445-5703
Other practice location 1
100 Ledgehill Rd
Bennington, VT 05201-5200
Phone (802) 442-5491
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6715970 | Medicaid | VT |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Bennington | Direct | |
| CONNECT URL | Bennington | Direct |
Other providers in Dorset, VT
- Miguel Guardado Avelar
- Bradford Marshall Hammond
- Jackson Peak Counseling, PLLC
- Judith M Kernodle
- Jody Lee Knapp
- Patricia A Michl
- Ewa S Mosiej-Polkosnik
- Mountain Valley, LLC
- Meredith Ozier
- Village Healthworks Chiro, LLC
All providers in Dorset, 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 Jul 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.