Active NPI
Heather Lynn Hastedt, LICSW
- Clinical Social Worker
- Waltham, MA
National Provider Identifier
1023345980
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 120080
- Practice address
- 20 Hope Ave Ste 111
Waltham, MA 02453 - Phone
- (617) 612-5202
- NPI assigned
- Nov 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801089430 | MI | |
| Clinical Social Worker | 1041C0700X | 120080 | MA | Primary |
Addresses
Primary practice location
20 Hope Ave Ste 111
Waltham, MA 02453
Mailing address
23 Dix St # 2
Waltham, MA 02453-6504
Phone (248) 770-0294
Other practice location 1
96 W 15th St
Suite 106
Holland, MI 49423-3370
Phone (616) 582-4998
Other practice location 2
20 Hope Ave Ste 111
Waltham, MA 02453
Phone (617) 612-5202
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120080 | MA | MD | Clinical Social Worker |
| 6801089430 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563494400000",
"number": "1023345980",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 DIX ST # 2",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024536504",
"telephone_number": "248-770-0294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 HOPE AVE STE 111",
"city": "WALTHAM",
"state": "MA",
"postal_code": "02453",
"telephone_number": "617-612-5202"
}
],
"practiceLocations": [
{
"address_1": "96 W 15th St",
"address_2": "Suite 106",
"address_purpose": "LOCATION",
"city": "Holland",
"state": "MI",
"postal_code": "494233370",
"country_code": "US",
"telephone_number": "616-582-4998",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "20 Hope Ave Ste 111",
"address_purpose": "LOCATION",
"city": "Waltham",
"state": "MA",
"postal_code": "02453",
"country_code": "US",
"telephone_number": "617-612-5202",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HASTEDT",
"first_name": "HEATHER",
"middle_name": "LYNN",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-12",
"last_updated": "2019-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801089430",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "120080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.