Provider Demographics
NPI:1225401136
Name:ACUS, KATHRINE (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:KATHRINE
Middle Name:
Last Name:ACUS
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:MISS
Other - First Name:KATHRINE
Other - Middle Name:
Other - Last Name:BALDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MT-BC
Mailing Address - Street 1:208 FLYNN AVE STE 3J
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5420
Mailing Address - Country:US
Mailing Address - Phone:802-488-6920
Mailing Address - Fax:
Practice Address - Street 1:1138 PINE ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-488-6000
Practice Address - Fax:802-488-6919
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS15009471041C0700X
VT089-01341311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical