Kerry McCracken Ducolon, LICSW
Individual provider Active NPI Clinical Social Worker · Burlington, VT
NPI 1851458749 · NPPES record last updated Mar 25, 2011
Key facts
- NPI
- 1851458749
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089-0000907 (VT)
- Practice address
- 1138 Pine St
Burlington, VT 05401-5353 - Phone
- (802) 488-6600
- Fax
- (802) 488-6600
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089-0000907 | VT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0000907 | VT | Yes |
Addresses
Primary practice location
1138 Pine St
Burlington, VT 05401-5353
Mailing address
208 Flynn Ave
36J
Burlington, VT 05401-5429
Phone (802) 488-6900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010387 | Medicaid | VT |
Other providers in Burlington, VT
- Nancy Jeanne McClellan
- Melissa McConnell
- Charlotte McCorkel
- Ashley Lynn McCormick
- Maisha McCormick
- Laura Wright McCray
- Tara McCuin
- Declan McDaid
- Cambria Eve McDermott
- Warren Patrick McDermott
All providers in Burlington, VT · Clinical Social Worker in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.