Shana Kotelchuck, LICSW - Medicare Clinical Social Worker in Randolph, VT

Shana Kotelchuck, LICSW is a medicare enrolled "Social Worker - Clinical" provider in Randolph, Vermont. Her current practice location is 11 S Main St, Randolph, Vermont. You can reach out to her office (for appointments etc.) via phone at (802) 728-4466.

Shana Kotelchuck is licensed to practice in Vermont (license number 089-0001123) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1073648895.

Contact Information

Shana Kotelchuck, LICSW
11 S Main St,
Randolph, VT 05060-1330
(802) 728-4466
(802) 728-4197



Healthcare Provider's Profile

Full NameShana Kotelchuck
GenderFemale
SpecialitySocial Worker - Clinical
Location11 S Main St, Randolph, Vermont
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1073648895
  • Provider Enumeration Date: 02/22/2007
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 8628177540
  • Enrollment ID: I20070619000072

Medical Identifiers

Medical identifiers for Shana Kotelchuck such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073648895NPI-NPPES
1013367MedicaidVT

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical 089-0001123 (Vermont)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shana Kotelchuck is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Shana Kotelchuck, LICSW
160 Shady Rill Rd,
Middlesex, VT 05602-9370

Ph: (802) 223-2655
Shana Kotelchuck, LICSW
11 S Main St,
Randolph, VT 05060-1330

Ph: (802) 728-4466

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› Verified 9 days ago


Social Worker in Randolph, VT

Nancy Copeland, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 11 S Main St, Randolph, VT 05060
Phone: 802-728-4466    Fax: 802-728-4197
James Tautfest, RN
Clinical Social Worker
Medicare: Accepting Medicare Assignments
Practice Location: 44 S Main St, Randolph, VT 05060
Phone: 802-728-7000    Fax: 802-728-2613
Alida Shriber, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 11 S Main St, Randolph, VT 05060
Phone: 802-728-4466    Fax: 802-728-4197
Margaret Hammond, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 11 S Main St, Randolph, VT 05060
Phone: 802-728-4466    Fax: 802-728-4197
Mrs. Nathalie C Sugarman, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 11 N Main St, Randolph, VT 05060
Phone: 802-728-4466    Fax: 802-728-4926
Joshua B Amses, LICSW
Clinical Social Worker
Medicare: Not Enrolled in Medicare
Practice Location: 11 N Main St, Randolph, VT 05060
Phone: 802-728-4466    Fax: 802-728-4197

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