Individual provider Active NPI

Eleanor Teresa Grabach, LCSW

  • Clinical Social Worker
  • Rutland, VT
National Provider Identifier
1740282276
Registry record updated Sep 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0105654 Issued in VT
Practice address
215 Stratton Rd
Rutland, VT 05701-4621
Phone
(802) 773-3386
Fax
(802) 773-4578
NPI assigned
Aug 15, 2005
Last updated
Sep 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW5774 FL
Clinical Social Worker 1041C0700X 1624 NH
Clinical Social Worker 1041C0700X 089-0105654 VT Primary

Addresses

Primary practice location

215 Stratton Rd
Rutland, VT 05701-4621

Mailing address

215 Stratton Rd
Rutland, VT 05701-4621
Phone (802) 855-2027

Other identifiers 2

IdentifierTypeStateIssuer
04183006MedicaidNY
1024723MedicaidVT

Other names 1

  • Eleanor Teresa Wheeler Former name

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
I20150717000029 VT Practitioner - Clinical Social Worker 4284947409 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Centers of the Rutland Region IncGroup PAC ID 2961467386, shared by 9 NPIs, 103 clinicians

Practice addresses (Care Compare)

231 N Main St
Rutland, VT 05701-2412
Phone (800) 468-9118

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW5774FLMDClinical Social Worker
089-0105654VTMDClinical Social Worker
1624NHMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 18, 2018 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 18, 2018 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 18, 2018 Accepting new patients
Community Health Centers of the Rutland Region Inc CurrentSince Apr 21, 2015 Accepting new patients
Community Health Centers of the Rutland Region Inc CurrentSince Apr 21, 2015 Accepting new patients
Community Health Centers of the Rutland Region, Inc. CurrentSince Dec 18, 2018 Accepting new patients
Community Health Centers of the Rutland Region, Inc Past Accepting new patients

Locations

275 VT 30 N
Bomoseen, VT 05732
Phone (802) 468-5641

420 Grove St
Brandon, VT 05733
Phone (802) 247-6305

1 General Wing Rd
Rutland, VT 05701
Phone (802) 773-9131

215 Stratton Rd
Rutland, VT 05701
Phone (802) 773-3386

215 Stratton Rd
#1
Rutland, VT 05701

231 N Main St
Rutland, VT 05701
Phone (800) 468-9118

71 Allen St
Ste 402
Rutland, VT 05701
Phone (800) 468-9118

71 Allen St
Ste 403
Rutland, VT 05701
Phone (802) 772-4414

2987 Vt Route 22A
Shoreham, VT 05770
Phone (802) 897-7000

278 Vt Route 149
West Pawlet, VT 05775
Phone (800) 468-9118

Interoperability endpoints

  • Direct secure messaging: egrabach@chcrr.medentdirect.com

Organizations & group practices 7

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443139200000",
    "number": "1740282276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-855-2027",
            "fax_number": "802-855-2053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 STRATTON RD",
            "city": "RUTLAND",
            "state": "VT",
            "postal_code": "057014621",
            "telephone_number": "802-773-3386",
            "fax_number": "802-773-4578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABACH",
        "first_name": "ELEANOR",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2015-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5774",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1624",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0105654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04183006",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1024723",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "WHEELER",
            "middle_name": "TERESA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rutland, VT

Sources for this page

Verify at the official NPI Registry.