Provider Demographics
NPI:1265588396
Name:SOBEL, JANE (MSW)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:SOBEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ELLEN
Other - Last Name:MARCUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:84 MECHANIC ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BENNINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05257-9546
Mailing Address - Country:US
Mailing Address - Phone:802-447-0069
Mailing Address - Fax:802-447-0069
Practice Address - Street 1:84 MECHANIC ST
Practice Address - Street 2:
Practice Address - City:NORTH BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05257-9546
Practice Address - Country:US
Practice Address - Phone:802-447-0069
Practice Address - Fax:802-447-0069
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089-00000681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTOVN2547Medicaid
VTOVN2547Medicaid
VT5359Medicare UPIN