Individual provider Active NPI

George Stuart Leibowitz, PH.D.

  • Clinical Social Worker
  • Williston, VT
National Provider Identifier
1871827154
Registry record updated Sep 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890001214 Issued in VT
Practice address
25 Wentworth Dr
Williston, VT 05495-9733
Phone
(802) 878-4990
NPI assigned
Sep 19, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2009

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 0890001214 VT Primary

Addresses

Primary practice location

25 Wentworth Dr
Williston, VT 05495-9733

Mailing address

218 Hedgerow Dr
Shelburne, VT 05482-6879
Phone (802) 881-3276

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0890001214VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New England Counseling and Trauma Associate Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253318400000",
    "number": "1871827154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 HEDGEROW DR",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054826879",
            "telephone_number": "802-881-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WENTWORTH DR",
            "city": "WILLISTON",
            "state": "VT",
            "postal_code": "054959733",
            "telephone_number": "802-878-4990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIBOWITZ",
        "first_name": "GEORGE",
        "middle_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-19",
        "last_updated": "2009-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890001214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2009; 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.