Maria Theresia Crossman, MSW, LCSW
Individual provider Active NPI Clinical Social Worker · Newport, VT
NPI 1508129404 · NPPES record last updated Mar 18, 2019
Key facts
- NPI
- 1508129404
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2014 (NH)
- Practice address
- 615 E Main St
Newport, VT 05855-5829 - Phone
- (603) 627-3111
- NPI assigned
- Jun 17, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1329 VT Route 111
Derby, VT 05829-9485
Phone (802) 767-7333
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 |
|---|---|---|---|---|
| I20190607000249 | VT | Practitioner - Clinical Social Worker | 4082937651 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014 | NH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindful Pathways LLC | Current |
Accepting new patients |
Locations
615 E Main St
Newport, VT 05855
Phone (603) 204-7377
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C008948 | NC | |
| Clinical Social Worker | 1041C0700X | 089.0134157 | VT | |
| Clinical Social Worker | 1041C0700X | 2014 | NH | Yes |
Addresses
Primary practice location
615 E Main St
Newport, VT 05855-5829
Mailing address
371 Memphremagog VW
Newport, VT 05855-4927
Phone (603) 204-7377
Other practice location 1
148 Coolidge Ave
Manchester, NH 03102-3208
Phone (603) 627-3111 ext. 470
Other providers in Newport, VT
- Nicole Corbett
- Justin Correa
- Cassandra Crawford
- Jailyn Louise Crepeault
- Emily Cromie
- Donald D Dahlin
- Tonya M Davis
- Deering Counseling LLC
- Bryan A Dellaria
- Denise a. Niemira, M.D., P.C.
All providers in Newport, 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 Mar 18, 2019. 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.