Individual provider Active NPI

Carl Hilton Vanosdall, LICSW

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1710918073
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0001021 Issued in VT
Practice address
564 NE Ravenna Blvd
Seattle, WA 98115-6460
Phone
(206) 527-2266
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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
Clinical Social Worker 1041C0700X 089-0001021 VT Primary

Addresses

Primary practice location

564 NE Ravenna Blvd
Seattle, WA 98115-6460

Mailing address

PO Box 1003
Kingston, WA 98346-1003
Phone (802) 272-4037

Other practice location 1

297 N Main St
Ste 3
Barre, VT 05641-4503
Phone (802) 479-4083

Other identifiers 4

IdentifierTypeStateIssuer
00068055OtherVTBC/BS VT
2273134OtherVTCIGNA
360324OtherVTTRICARE
1010599MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20220610000735 WA Practitioner - Clinical Social Worker 1456330604 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Counseling ServiceGroup PAC ID 8325031040, 8 clinicians

Practice addresses (Care Compare)

564 NE Ravenna Blvd
Seattle, WA 98115-6460
Phone (206) 527-2266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0001021VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sarah D Counseling Services, LLC Clinical 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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1710918073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1003",
            "city": "KINGSTON",
            "state": "WA",
            "postal_code": "983461003",
            "telephone_number": "802-272-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 NE RAVENNA BLVD",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981156460",
            "telephone_number": "206-527-2266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "297 N MAIN ST",
            "address_2": "STE 3",
            "address_purpose": "LOCATION",
            "city": "BARRE",
            "state": "VT",
            "postal_code": "056414503",
            "country_code": "US",
            "telephone_number": "802-479-4083",
            "fax_number": "802-476-1476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HILTON VANOSDALL",
        "first_name": "CARL",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0001021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS VT",
            "identifier": "00068055",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2273134",
            "state": "VT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "360324",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1010599",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.