CAROLYN GILLIS I LIBERTY (LICSW) – Clinical Social Worker, NPI 1750413639

CAROLYN GILLIS I LIBERTY (LICSW) is a healthcare provider. based in Middlebury, Vermont. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LICSW. They hold a License No. 089-0001139 (VT). The NPI Number for CAROLYN GILLIS I LIBERTY (LICSW) is 1750413639

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
CAROLYN GILLIS I LIBERTY (LICSW)
NPI
1750413639
Phone
Not provided
Address
PO BOX 1045
Enumeration Date
9 March 2007
Last Update Date
13 August 2015

Doctor Profile

Medical School Name
UNIVERSITY OF VERMONT COLLEGE OF MEDICINE
Secondary Phone
8023886751
Graduation Year
2004 (22 years ago)
PAC ID
7012095128
Group Practice PAC ID
2062304439
Professional Enrollment ID
I20080415000353
Address ID
VT057531459MI89XXXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

436 CLINICAL SOCIAL WORKER in VT

Provider Addresses for CAROLYN GILLIS I LIBERTY (LICSW)

  • PO BOX 1045

    MIDDLEBURY, VT 057535045

    Phone:

    Type: Mailing

  • 89 MAIN ST

    MIDDLEBURY, VT 057531459

    Phone: (802) 388-6751

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-04-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20080415000353IClinical Social WorkerVTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
90834Psychotherapy, 45 minutes22212$0
View full utilization report →

Insurance plans in this area (ZIP 05753)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2062304439View full group profile
NameSpecialtyState
Clinical Social WorkerCA
Mental Health CounselorVT
Clinical Social WorkerVT
-VT
Nurse PractitionerVT
Clinical Social WorkerVT
Clinical Social WorkerVT
Clinical Social WorkerVT
Mental Health CounselorVT
-VT

Reviews

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Frequently asked questions

Is there an official ID for CAROLYN GILLIS I LIBERTY (LICSW) in U.S. healthcare records?
The official identifier for CAROLYN GILLIS I LIBERTY (LICSW) is NPI 1750413639.
Is CAROLYN GILLIS I LIBERTY (LICSW) shown as active in public data?
Registry records indicate CAROLYN GILLIS I LIBERTY (LICSW) maintains an active NPI.
What area of care is associated with CAROLYN GILLIS I LIBERTY (LICSW)?
CAROLYN GILLIS I LIBERTY (LICSW)'s record emphasizes Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CAROLYN GILLIS I LIBERTY (LICSW)?
Travel planning: use Middlebury, Vermont as the reference point for CAROLYN GILLIS I LIBERTY (LICSW), then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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