MEDICARE: JANE SOBEL MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	089-0000068	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265588396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE SOBEL MSW

Provider Business Mailing Address
First Line	:	84 MECHANIC ST
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-9546
Country	:	US
Telephone Number	:	802-447-0069
Fax Number	:	802-447-0069

Provider Business Practice Location Address
First Line	:	84 MECHANIC ST
Second Line	:
City	:	NORTH BENNINGTON
State	:	VT
Zip	:	05257-9546
Country	:	US
Telephone Number	:	802-447-0069
Fax Number	:	802-447-0069

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/09/2007

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