Individual provider Active NPI

Leila Wilson Bate, LICSW

  • Clinical Social Worker
  • Grafton, VT
National Provider Identifier
1699854083
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0000977 Issued in VT
Practice address
777 Wright Orchard Rd
Grafton, VT 05146-9769
Phone
(802) 843-1175
NPI assigned
Nov 4, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 089-0000977 VT Primary

Addresses

Primary practice location

777 Wright Orchard Rd
Grafton, VT 05146-9769

Mailing address

777 Wright Orchard Rd
Grafton, VT 05146-9769
Phone (802) 843-1175

Other identifiers 1

IdentifierTypeStateIssuer
1011808MedicaidVT

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
I20141208001188 VT Practitioner - Clinical Social Worker 7911229679 Practice locations: Brattleboro, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

70 Western Ave
Brattleboro, VT 05301-6096
Phone (802) 289-2233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0000977VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699854083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 WRIGHT ORCHARD RD",
            "city": "GRAFTON",
            "state": "VT",
            "postal_code": "051469769",
            "telephone_number": "802-843-1175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 WRIGHT ORCHARD RD",
            "city": "GRAFTON",
            "state": "VT",
            "postal_code": "051469769",
            "telephone_number": "802-843-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATE",
        "first_name": "LEILA",
        "middle_name": "WILSON",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011808",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grafton, VT

Sources for this page

Verify at the official NPI Registry.