Individual provider Active NPI

Jacqueline B Bilodeau

  • Clinical Social Worker
  • Derby, VT
National Provider Identifier
1467971895
Registry record updated Sep 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890130775 Issued in VT
Practice address
181 Crawford Road
Derby, VT 05829
Phone
(802) 334-6744
NPI assigned
Sep 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0890130775 VT Primary

Addresses

Primary practice location

181 Crawford Road
Derby, VT 05829

Mailing address

PO Box 376
Montgomery Center, VT 05471-0376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890130775VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1467971895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 376",
            "city": "MONTGOMERY CENTER",
            "state": "VT",
            "postal_code": "054710376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 CRAWFORD ROAD",
            "city": "DERBY",
            "state": "VT",
            "postal_code": "05829",
            "telephone_number": "802-334-6744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILODEAU",
        "first_name": "JACQUELINE",
        "middle_name": "B",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890130775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, VT

Sources for this page

Verify at the official NPI Registry.