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SHANA KOTELCHUCK LICSW
NPI 1073648895
Social Worker - Clinical in Randolph, VT

Active since February 22, 2007PECOS EnrolledAccepts Medicare Assignment
11 S MAIN ST, RANDOLPH, VT 05060(802) 728-4466(802) 728-4197 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Shana Kotelchuck Licsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANA KOTELCHUCK LICSW (NPI 1073648895) is an individual clinical provider in Randolph, Vermont, licensed in Vermont (089-0001123) and active in the NPI registry since February 2007. She is enrolled in Medicare PECOS and is a graduate of Other (2002).

NPPES Registry Identity

NPI1073648895
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameSHANA KOTELCHUCKCredential: LICSW
Location Address11 S MAIN STRandolph, VT 05060-1330
Mailing Address160 Shady Rill RdMiddlesex, VT 05602-9370 · (802) 223-2655
Phone(802) 728-4466
Fax(802) 728-4197
Sole ProprietorYes
Medical School CMSOtherGraduated 2002
Enumeration DateFebruary 22, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1073648895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in VT · 089-0001123
Definition
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.
11 S MAIN ST, Randolph, VT 05060
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Other Identifiers 1

Medicaid1013367VT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Shana Kotelchuck Licsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628177540
PECOS Enrollment IDI20070619000072
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 05060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $55.80 – $168.48
Typical copayment $0.00 (range $13.95 – $42.12)
Most-billed visit code NA
Established Patient
$69.56 typical visit price
range $18.08 – $137.84
Typical copayment $17.39 (range $4.52 – $34.46)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENEE WEEKS LCMHC
Counselor (Mental Health)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
DAVID PELLEGRINO LCMHC
Counselor (Mental Health)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
NANCY COPELAND LICSW
Social Worker (Clinical)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
HOWARD HOOD LCMHC
Counselor (Mental Health)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
KERRIE TAYLOR LCMHC
Counselor (Mental Health)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
ALIDA SHRIBER LICSW
Social Worker (Clinical)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
MS. ANNIE LUKE MA, LADC
Counselor (Addiction (Substance Use Disorder))
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466
CLARA MARTIN CENTER
Clinic/Center (Rehabilitation, Substance Use Disorder)
11 S MAIN ST
RANDOLPH, VT 05060
Orange County (802) 728-4466

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shana Kotelchuck's NPI number?

The NPI number for Shana Kotelchuck is 1073648895. It was assigned to this individual provider in the NPPES registry on February 22, 2007.

Where is Shana Kotelchuck located?

Shana Kotelchuck practices at 11 S Main St, Randolph, VT 05060. The listed phone number is (802) 728-4466.

What is Shana Kotelchuck's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Shana Kotelchuck enrolled in Medicare?

Yes. Shana Kotelchuck is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Shana Kotelchuck accept?

Health plans from Anthem Blue Cross and Blue Shield list Shana Kotelchuck as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shana Kotelchuck was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.