Individual provider Active NPI

Rebecca Van Tassel, LCSW

  • Clinical Social Worker
  • Austin, TX
National Provider Identifier
1083976070
Registry record updated Mar 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
55866 Issued in TX
Practice address
821 W 11TH St
Austin, TX 78701-2009
Phone
(713) 391-9966
Fax
(512) 727-0846
NPI assigned
Jun 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801092462 MI
Clinical Social Worker 1041C0700X 55866 TX Primary

Addresses

Primary practice location

821 W 11TH St
Austin, TX 78701-2009

Mailing address

821 W 11TH St
Austin, TX 78701-2009
Phone (713) 391-9966

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

LicenseStateTypeSpecialty
6801092462MIMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647820800000",
    "number": "1083976070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 W 11TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012009",
            "telephone_number": "713-391-9966",
            "fax_number": "512-727-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W 11TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787012009",
            "telephone_number": "713-391-9966",
            "fax_number": "512-727-0846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSEL",
        "first_name": "REBECCA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-14",
        "last_updated": "2022-03-21",
        "certification_date": "2022-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801092462",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "55866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.