Amy Breese, LICSW
Individual provider Active NPI Clinical Social Worker · Bennington, VT
NPI 1942524533 · NPPES record last updated Mar 28, 2021
Key facts
- NPI
- 1942524533
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 089.0129453 (VT)
- Practice address
- 937 Gage St
Bennington, VT 05201-2069 - Phone
- (518) 469-8704
- NPI assigned
- Mar 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
937 Gage St
Bennington, VT 05201-2069
Phone (518) 469-8704
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180713001261 | VT | Practitioner - Clinical Social Worker | 7719233287 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 089.0129453 | VT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amy Breese, Licsw, LLC | Clinical | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Doula | 374J00000X | NY | ||
| Clinical Social Worker | 1041C0700X | 089.0129453 | VT | Yes |
Addresses
Primary practice location
937 Gage St
Bennington, VT 05201-2069
Mailing address
100 Ledgehill Rd
Bennington, VT 05201-2273
Other practice location 1
9 Church St
Arlington, VT 05250
Phone (802) 375-6566
Other providers in Bennington, VT
- Emilee Bonnier
- Kansinya Boone
- Bethany Marie Boulger
- Jennifer Boyer
- Allison Bradley
- Theresa Brickey
- Bridget H Bromirski
- Megan Brooks
- Brookside Pediatrics & Adolescent Medicine PLLC
- Claudia Brown
All providers in Bennington, 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 28, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.