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JOHN SURPRENANT LICSW
NPI 1609615319
Social Worker - Clinical in Burlington, VT

Active since May 22, 2024PECOS Enrolled
1138 PINE ST, BURLINGTON, VT 05401(802) 488-6000(802) 488-6919 Get Directions Write a Review

NPPES record last updated: May 22, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About John Surprenant Licsw NPPES

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

JOHN SURPRENANT LICSW (NPI 1609615319) is an individual clinical provider in Burlington, Vermont, licensed in Vermont (089.0135564) and active in the NPI registry since May 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1609615319
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameJOHN SURPRENANTCredential: LICSW
Location Address1138 PINE STBurlington, VT 05401-5353
Mailing Address208 Flynn Ave Ste 3jBurlington, VT 05401-5420 · (802) 488-6920 · Fax (802) 488-6919
Phone(802) 488-6000
Fax(802) 488-6919
Sole ProprietorNo
Enumeration DateMay 22, 2024
NPPES CertifiedMay 22, 2024
✔ NPI 1609615319 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 · 089.0135564
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.
1138 PINE ST, Burlington, VT 05401
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Other Names 1

Other Name (5)Rusty Surprenant Licsw

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John Surprenant Licsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 05401 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.

CHRISTINA VETTER RAISANEN BCBA
Behavior Analyst
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6000
SHANNON KADISH LICSW
Social Worker (Clinical)
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6600
ELYZA MOORE LICSW
Social Worker (Clinical)
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6000
ELLYN LEAMON LICSW
Social Worker (Clinical)
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 863-1326
LORA GIGUERE
Community Health Worker
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6000
ANDREA FINE
Student in an Organized Health Care Education/Training Program
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6000
ADAM FROWINE LICSW
Social Worker (Clinical)
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6000
CHRISTOPHER SPODICK
Community Health Worker
1138 PINE ST
BURLINGTON, VT 05401
Chittenden County (802) 488-6000

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 John Surprenant's NPI number?

The NPI number for John Surprenant is 1609615319. It was assigned to this individual provider in the NPPES registry on May 22, 2024. The provider is also known as Rusty Surprenant Licsw.

Where is John Surprenant located?

John Surprenant practices at 1138 Pine St, Burlington, VT 05401. The listed phone number is (802) 488-6000.

What is John Surprenant's specialty?

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

Is John Surprenant enrolled in Medicare?

Yes. John Surprenant is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for John Surprenant was last updated on May 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.