Ellen Marie Duval, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089-0000778 Issued in VT

Practice address

157 Maple St.
#3
Jeffersonville, VT 05464

Phone

(802) 644-6758

NPI assigned

Oct 12, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568551703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413",
            "city": "JEFFERSONVILLE",
            "state": "VT",
            "postal_code": "054640413",
            "telephone_number": "802-644-6758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 MAPLE ST.",
            "address_2": "#3",
            "city": "JEFFERSONVILLE",
            "state": "VT",
            "postal_code": "05464",
            "telephone_number": "802-644-6758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVAL",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012011",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Cahill
• Cambridge Rescue Squad Inc.
• Center for Trauma Recovery LLC (Center for Trauma Recovery)
• Gina M Ciancia, RN
• John M Dunn, MD
• Robin Erickson, MS, LCMHC
• Eleanor Gagne
• Allison Graham, MA
• Josha Anne Grant, MA
• Ann Kathy Greer, LCMHC, LADC

• Clinical Social Worker in Jeffersonville, VT
• Providers in Jeffersonville, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.