Individual provider Active NPI

Christina Allen, LICSW

  • Clinical Social Worker
  • South Burlington, VT
National Provider Identifier
1740336924
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-00001085 Issued in VT
Practice address
595 Dorset St Ste 2
South Burlington, VT 05403-6240
Phone
(802) 651-8999
Fax
(802) 651-8997
NPI assigned
Jan 28, 2007
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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 089-00001085 VT Primary

Addresses

Primary practice location

595 Dorset St Ste 2
South Burlington, VT 05403-6240

Mailing address

595 Dorset St Ste 2
South Burlington, VT 05403-6240
Phone (802) 651-8999

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
I20070514000357 VT Practitioner - Clinical Social Worker 2961509732 Practice locations: South Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

595 Dorset St
Suite 2
South Burlington, VT 05403-6240
Phone 80265189993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-00001085VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Psychotherapy LLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

595 Dorset St
Ste 2
South Burlington, VT 05403
Phone (802) 557-0128

Organizations & group practices 1

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": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1740336924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 DORSET ST STE 2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036240",
            "telephone_number": "802-651-8999",
            "fax_number": "802-651-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 DORSET ST STE 2",
            "city": "SOUTH BURLINGTON",
            "state": "VT",
            "postal_code": "054036240",
            "telephone_number": "802-651-8999",
            "fax_number": "802-651-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "CHRISTINA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-28",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-00001085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Burlington, VT

Sources for this page

Verify at the official NPI Registry.