Individual provider Active NPI

Roberta L. Paley, LICSW

  • Clinical Social Worker
  • Brattleboro, VT
National Provider Identifier
1619992989
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0088361 Issued in VT
Practice address
14 Park PL
2ND Floor
Brattleboro, VT 05301-2821
Phone
(802) 275-7492
Fax
(802) 579-1509
NPI assigned
Jul 13, 2006
Last updated
Nov 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 089.0088361 VT Primary
Clinical Social Worker 1041C0700X R043140-1 NY

Addresses

Primary practice location

14 Park PL
2ND Floor
Brattleboro, VT 05301-2821

Mailing address

14 Park PL
2ND Floor
Brattleboro, VT 05301-2821
Phone (718) 336-0641

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
I20160322002167 VT Practitioner - Clinical Social Worker 2365427390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14 Park PL
FL 2
Brattleboro, VT 05301-2821
Phone (802) 246-1470

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R043140-1NYMDClinical Social Worker
089.0088361VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Whetstone Counseling, LLC CurrentSince Dec 21, 2015 Accepting new patients
Park Slope Center for Mental Health, Inc PastSince Oct 11, 2005 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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1619992989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 PARK PL",
            "address_2": "2ND FLOOR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053012821",
            "telephone_number": "718-336-0641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 PARK PL",
            "address_2": "2ND FLOOR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053012821",
            "telephone_number": "802-275-7492",
            "fax_number": "802-579-1509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALEY",
        "first_name": "ROBERTA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0088361",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R043140-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.