MR. DANIEL BASLOCK (NPI# 1013217546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013217546 |
| Entity Type | Individual |
| Full Name | MR. DANIEL BASLOCK |
| Credential | MSW |
| Practice Address |
190 Eastern Ave St Johnsbury VT 05819-5606 |
| Mailing Address |
25 Hilltop Ave Barre VT 05641-4327 |
| Practice Telephone | 8025359114 |
| Mailing Telephone | 8025359114 |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
151.0126712 | VT | Behavioral Health & Social Service Providers |
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
089.0090488 | VT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | 1022005 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 286 Hospital Loop, Berlin, VT 056029523 | 8022290591 | 8022233667 |
| Street Address |
190 EASTERN AVE |
| City | ST JOHNSBURY |
| State | VT |
| Zip Code | 05819-5606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699815118 | Kathryn Marie Cote | Social Worker | 190 Eastern Ave, Ste 205, St Johnsbury, VT 05819-5600 | 2007-02-07 |
| 1578780615 | Dennis Richard Casey | Counselor | 190 Eastern Ave, St Johnsbury, VT 05819-5606 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710457353 | Amber L Carrasquillo | Pharmacist | 438 Railroad St Apt 301, Saint Johnsbury, VT 05819 | 2018-11-27 |
| 1700378734 | Laura Amy Nixon | Physician Assistant | 41 Sherman Drive, St. Johnsbury, VT 05819 | 2018-06-05 |
| 1447797873 | Kingdom Autism and Behavioral Health, LLC | Behavioral Analyst | 397 Railroad Street, Suite Number #4, St. Johnsbury, VT 05819 | 2017-01-24 |
| 1407211493 | Scott Rosemark | Pharmacist | 957 Memorial Drive, Saint Johnsbury, VT 05819 | 2015-12-18 |
| 1134541295 | Meghan Davis | Counselor | 231 Concord Ave Ste 2, St Johnsbury, VT 05819 | 2014-01-09 |
| 1639490279 | Carol Lynn Smith | Counselor | 445 Portland St, St. Johnsbury, VT 05819 | 2010-06-17 |
| 1548435696 | Philip Lightbear | Counselor | 108 Cherry Street Suite 1, St Johnsburg, VT 05819 | 2008-04-29 |
| 1740452416 | Kimberly Dena Lightbear | Counselor | 108 Cherry Street, St Johnsbury, VT 05819 | 2008-04-02 |
| 1720262249 | Deborah B Goldberg | Psychologist | 1194 Main Street, Suite 107, St Johnsbury, VT 05819 | 2007-12-19 |
| 1154501880 | Mary Jane Egerton | Social Worker | 506 Tripp Lane, St Johnsburg, VT 05819 | 2007-11-09 |
| Find all providers in zip 05819 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255994679 | Simone Cote | Social Worker | 190 Eastern Ave Ste 5, St Johnsbury, VT 05819-5600 | 2019-04-22 |
| 1699815118 | Kathryn Marie Cote | Social Worker | 190 Eastern Ave, Ste 205, St Johnsbury, VT 05819-5600 | 2007-02-07 |
| 1790713998 | Marilyn Mcenery | Social Worker | 1194 Main St, Suite 2, St Johnsbury, VT 05819-2773 | 2006-06-28 |
| 1174571418 | David J Truslow | Social Worker | 1129 Main Street, St Johnsbury, VT 05819-0362 | 2006-05-05 |
| 1023551710 | Jin Li Chan | Social Worker | 714 Breezy Hill Rd, St Johnsbury, VT 05819-8882 | 2016-11-29 |
| 1003275397 | Katherine A. Harris | Social Worker | 1315 Hospital Dr, St Johnsbury, VT 05819-9210 | 2016-02-16 |
| 1316221039 | Robert Michael Norris | Social Worker | 161 Sherman Dr, St Johnsbury, VT 05819-9811 | 2011-09-29 |
| 1699826602 | Bonita E Fazio | Social Worker | 297 Summer St, Kingdom Recovery Center, St Johnsbury, VT 05819-2283 | 2007-01-16 |
| 1609880319 | Sara J Demetry | Social Worker | 231 Concord Ave, Suite #2, St Johnsbury, VT 05819 | 2006-07-28 |
| 1669438131 | Betsy A Fowler | Social Worker | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-8882 | 2006-04-25 |
| Find all providers in ST JOHNSBURY | ||||
| City | ST JOHNSBURY |
| Zip Code | 05819 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.