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Nancy J Desrault

Social Worker

Behavioral Health & Social Service Providers

431 Pine Street, The Maltex Bldg, Burlington, VT 05401

PECOS Enrollment

This provider is enrolled in PECOS as NANCY DESRAULT.

Based on the most recent information from CMS, provider Nancy J Desrault is legally eligible to order and refer claims for Part B and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1174666515
Provider Type
Individual
Full Name
Desrault, Nancy J
Credential
MSW LICSW

Gender
Female
Sole Proprietor
No
Enumeration Date
2/15/2007
Last Updated
7/8/2007

Contact Information

Practice Location

431 Pine Street, The Maltex Bldg, Burlington, VT 05401

(802) 865-9873

(802) 865-9877

Mailing Location

431 Pine Street, The Maltex Bldg, Burlington, VT 05401

(802) 865-9873

(802) 865-9877

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 0890000347 Vermont
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License SW0063286 Pennsylvania

Nancy J Desrault

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

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