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

Q: 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.

Q: What is Jacqueline Eddy's specialty?

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

Q: 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.

Q: When was this NPI record last updated?

The NPPES record for Jacqueline Eddy was last updated on July 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

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: August 09, 2026.

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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

Phone(802) 775-8224

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

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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.

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