Individual provider Active NPI

Susanae H Glovacki, MSW

  • Clinical Social Worker
  • Brattleboro, VT
National Provider Identifier
1700904307
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089.0000932 Issued in VT
Practice address
51 Fairview Street
Brattleboro, VT 05301
Phone
(802) 254-7500
Fax
(802) 254-7501
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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 089.0000932 VT Primary

Addresses

Primary practice location

51 Fairview Street
Brattleboro, VT 05301

Mailing address

390 River Street
Springfield, VT 05156
Phone (802) 886-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
089.0000932VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. Past Accepting new patients
Health Care and Rehabilitation Services of Southeastern Vermont, Inc. Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540425600000",
    "number": "1700904307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 RIVER STREET",
            "city": "SPRINGFIELD",
            "state": "VT",
            "postal_code": "05156",
            "telephone_number": "802-886-4500",
            "fax_number": "802-886-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 FAIRVIEW STREET",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "05301",
            "telephone_number": "802-254-7500",
            "fax_number": "802-254-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLOVACKI",
        "first_name": "SUSANAE",
        "middle_name": "H",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2018-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089.0000932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.