Individual provider Active NPI

Jennifer Katherine Daley, LICSW

  • Clinical Social Worker
  • South Burlington, VT
National Provider Identifier
1568436467
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890000998 Issued in VT
Practice address
1 Kennedy Dr Ste L5
South Burlington, VT 05403-7165
Phone
(802) 448-2138
NPI assigned
Feb 15, 2006
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 0890000998 VT Primary

Addresses

Primary practice location

1 Kennedy Dr Ste L5
South Burlington, VT 05403-7165

Mailing address

1 Kennedy Dr Ste L5
South Burlington, VT 05403-7165
Phone (802) 448-2138

Other identifiers 1

IdentifierTypeStateIssuer
1010504MedicaidVT

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
I20050304000740 VT Practitioner - Clinical Social Worker 1456305135 Practice locations: South Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1233 Shelburne Rd
Suite 120
South Burlington, VT 05403-7752
Phone (802) 448-2138

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890000998VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Audiology Associates, PC PastSince Mar 31, 2025 Accepting new patients
Adirondack Audiology Associates Hearing and Balance Center LLC PastSince Nov 7, 2009 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1568436467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR STE L5",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037165",
            "telephone_number": "802-448-2138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KENNEDY DR STE L5",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054037165",
            "telephone_number": "802-448-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEY",
        "first_name": "JENNIFER",
        "middle_name": "KATHERINE",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890000998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010504",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.