Individual provider Active NPI

Heidi Hakey, LICSW

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1710460886
Registry record updated Sep 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0134127 Issued in VT
Practice address
855 Pine St
Burlington, VT 05401-4924
Phone
(802) 488-6900
Fax
(802) 488-6919
NPI assigned
Sep 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 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 089-0134127 VT Primary

Addresses

Primary practice location

855 Pine St
Burlington, VT 05401-4924

Mailing address

208 Flynn Ave Ste 3J
Burlington, VT 05401-5420
Phone (802) 488-6900

Other names 1

  • Heidi Rucker Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0134127VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1710460886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 FLYNN AVE STE 3J",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015420",
            "telephone_number": "802-488-6900",
            "fax_number": "802-488-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 PINE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014924",
            "telephone_number": "802-488-6900",
            "fax_number": "802-488-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAKEY",
        "first_name": "HEIDI",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0134127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEIDI",
            "last_name": "RUCKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Burlington, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.