JACQUELINE M EDDY LICSW
NPI 1114570371
Social Worker - Clinical in Rutland, VT

Active since July 17, 2019Opted out of Medicare · through Mar 3, 2028
78 S MAIN ST, RUTLAND, VT 05701(802) 775-8224(802) 747-7699 Get Directions Write a Review

NPPES record last updated: July 17, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Jacqueline M Eddy Licsw NPPES

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

JACQUELINE M EDDY LICSW (NPI 1114570371) is an individual clinical provider in Rutland, Vermont, licensed in Vermont (0890134209) and active in the NPI registry since July 2019. She has opted out of Medicare through March 3, 2028.

NPPES Registry Identity

NPI1114570371
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameJACQUELINE M EDDYCredential: LICSW
Location Address78 S MAIN STRutland, VT 05701-4594
Mailing Address78 S Main StRutland, VT 05701-4594 · (802) 775-8224 · Fax (802) 747-7699
Fax(802) 747-7699
Sole ProprietorYes
Enumeration DateJuly 17, 2019
NPI 1114570371 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 · 0890134209
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.

78 S MAIN ST, Rutland, VT 05701

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Jacqueline M Eddy Licsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 3, 2024 through March 3, 2028.

Opt-Out Effective DateMarch 3, 2024
Opt-Out In Effect ThroughMarch 3, 2028Opt-out affidavits renew automatically every two years unless cancelled

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.

Psychologist (Clinical)
78 S MAIN ST
RUTLAND, VT 05701
Social Worker (Clinical)
78 S MAIN ST
RUTLAND, VT 05701
Social Worker (Clinical)
78 S MAIN ST
RUTLAND, VT 05701
Social Worker (Clinical)
78 S MAIN ST
RUTLAND, VT 05701
Counselor (Addiction (Substance Use Disorder))
78 S MAIN ST
RUTLAND, VT 05701
Social Worker
78 S MAIN ST
RUTLAND, VT 05701
Counselor (Mental Health)
78 S MAIN ST
RUTLAND, VT 05701
Counselor
78 S MAIN ST
RUTLAND, VT 05701

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 Jacqueline Eddy's NPI number?

The NPI number for Jacqueline Eddy is 1114570371. It was assigned to this individual provider in the NPPES registry on July 17, 2019.

Where is Jacqueline Eddy located?

Jacqueline Eddy practices at 78 S Main St, Rutland, VT 05701. The listed phone number is (802) 775-8224.

What is Jacqueline Eddy's specialty?

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

Is Jacqueline Eddy enrolled in Medicare?

No. Jacqueline Eddy has opted out of Medicare through March 3, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jacqueline Eddy was last updated on July 17, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.