Patricia Doherty, Licsw, PLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

89.0000877 Issued in VT

Legal business name

PATRICIA DOHERTY, LICSW, PLC

Practice address

1205 North Ave
Burlington, VT 05408-2804

Phone

(802) 489-5665

NPI assigned

Nov 10, 2016

Last updated

Nov 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Patricia Judith Doherty, LICSW

Title

Psychotherapist

Phone

(802) 825-6910

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1760924450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 NORTH AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054082804",
            "telephone_number": "802-489-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 NORTH AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054082804",
            "telephone_number": "802-489-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA DOHERTY, LICSW, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "JUDITH",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "802-825-6910",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "89.0000877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023503",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pathways Vermont, Inc.
• Patricia Ann Pati, PHD
• Sanjeev Patil, M.D
• Julia Spencer Patkin
• Sonja Patno, LICSW
• Katherine S Patrick, MD
• Cyrus Patten, LICSW
• Charles Patterson
• Todd Eric Patterson, OTR/L
• Paul Foxman, PH.D., Inc.

• Clinical Social Worker in Burlington, VT
• Providers in Burlington, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.