Individual provider Active NPI

William Schubart, LICSW

  • Clinical Social Worker
  • Burlington, VT
National Provider Identifier
1841595915
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890072687 Issued in VT
Practice address
86 Lake St
Burlington, VT 05401-5297
Phone
(802) 865-3450
Fax
(802) 860-5011
NPI assigned
Jan 20, 2011
Last updated
Jan 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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 0890072687 VT Primary

Addresses

Primary practice location

86 Lake St
Burlington, VT 05401-5297

Mailing address

86 Lake St
Burlington, VT 05401-5297
Phone (802) 865-3450

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
I20110408000364 VT Practitioner - Clinical Social Worker 9638353014 Practice locations: Burlington, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

86 Lake St
Burlington, VT 05401-5297
Phone (802) 865-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0890072687VTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1841595915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015297",
            "telephone_number": "802-865-3450",
            "fax_number": "802-860-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 LAKE ST",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015297",
            "telephone_number": "802-865-3450",
            "fax_number": "802-860-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUBART",
        "first_name": "WILLIAM",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890072687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.