Individual provider Active NPI

Amelia A. Gerlin, LICSW

  • Clinical Social Worker
  • Shelburne, VT
National Provider Identifier
1992814974
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
089-0001103 Issued in VT
Practice address
20 Farmstead Dr
Shelburne, VT 05482-6907
Phone
(802) 557-4841
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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 089-0001103 VT Primary

Addresses

Primary practice location

20 Farmstead Dr
Shelburne, VT 05482-6907

Mailing address

20 Farmstead Dr
Shelburne, VT 05482-6907
Phone (802) 985-9255

Other identifiers 1

IdentifierTypeStateIssuer
1012613MedicaidVT

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
I20061215000204 VT Practitioner - Clinical Social Worker 6507865730 Receives reassigned benefits from 2 practitioners
Practice locations: Shelburne, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

20 Farmstead Dr
Shelburne, VT 05482-6907
Phone (802) 557-4841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
089-0001103VTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Green Mountain Eldercare Clinical CurrentSince Oct 1, 2014 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1992814974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FARMSTEAD DR",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054826907",
            "telephone_number": "802-985-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FARMSTEAD DR",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054826907",
            "telephone_number": "802-557-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLIN",
        "first_name": "AMELIA",
        "middle_name": "A.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0001103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012613",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelburne, VT

Sources for this page

Verify at the official NPI Registry.