Mr Gordon Wayne Petersen, MSW, LICSW in Burlington, VT

Mr Gordon Wayne Petersen, MSW, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Burlington, Vermont. His current practice location is 166 Battery St, Burlington, Vermont. You can reach out to his office (for appointments etc.) via phone at (802) 862-3373.

Mr Gordon Wayne Petersen is licensed to practice in Vermont (license number 089-0000142) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1487746244.

Contact Information

	Mr Gordon Wayne Petersen, MSW, LICSW
	166 Battery St, Burlington, VT 05401-5283
	(802) 862-3373
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Mr Gordon Wayne Petersen
Gender	Male
Speciality	Social Worker - Clinical
Location	166 Battery St, Burlington, Vermont
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487746244
Provider Enumeration Date: 09/29/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 2062575491
Enrollment ID: I20090112000604

Medical Identifiers

Medical identifiers for Mr Gordon Wayne Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487746244	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1041C0700X	Social Worker - Clinical	089-0000142 (Vermont)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Gordon Wayne Petersen allows following entities to bill medicare on his behalf.

Entity Name	Workplace Solutions, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720227325 PECOS PAC ID: 2365507365 Enrollment ID: O20090206000346

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Gordon Wayne Petersen is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Gordon Wayne Petersen, MSW, LICSW 763 North Ave, Burlington, VT 05401-2728 Ph: (802) 862-9067	Mr Gordon Wayne Petersen, MSW, LICSW 166 Battery St, Burlington, VT 05401-5283 Ph: (802) 862-3373

Reviews and Comments

Social Worker in Burlington, VT

Shannon Kadish, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6600
Elyza Moore, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6000 Fax: 802-488-6919
Ellyn Leamon, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-863-1326
Allison Holley Capeless, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 50 Lakeside Ave, Burlington, VT 05401 Phone: 312-519-5675
Lauren Carpenter, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 617 Riverside Ave, Burlington, VT 05401 Phone: 802-864-6309
Adam Frowine, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1138 Pine St, Burlington, VT 05401 Phone: 802-488-6000 Fax: 802-488-6919
Elaine Soto, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 300 Flynn Ave, Burlington, VT 05401 Phone: 802-488-6000 Fax: 802-488-6919

Mr Gordon Wayne Petersen, MSW, LICSW - Medicare Clinical Social Worker in Burlington, VT