Individual provider Active NPI

Molly S Van Wert, LICSW

  • Clinical Social Worker
  • Lexington, MA
National Provider Identifier
1104076702
Registry record updated Mar 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
117182 Issued in MA
Practice address
2 Stevens Rd
Lexington, MA 02421-4115
Phone
(617) 866-9327
NPI assigned
Sep 19, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X S65948197 MA
Clinical Social Worker 1041C0700X 117182 MA Primary

Addresses

Primary practice location

2 Stevens Rd
Lexington, MA 02421-4115

Mailing address

2 Stevens Rd
Lexington, MA 02421-4115
Phone (617) 866-9327

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130522000305 MA Practitioner - Clinical Social Worker 2365680840 Reassigns benefits to 1 organization
I20241216000114 ME Practitioner - Clinical Social Worker 2365680840 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117182MAMDClinical Social Worker
S65948197MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
R.I.S.E. Integrated Mental Health PLLC CurrentSince Oct 8, 2024 Accepting new patients
The McLean Hospital Corporation Clinical CurrentSince Apr 4, 2013 Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

15 Sky View Dr
Ste 200
Cumberland Foreside, ME 04110
Phone (207) 630-2922

4 Market Place Dr
Unit 12
York, ME 03909
Phone (207) 630-2922

4 Market Place Dr
Ste 12
York, ME 03909
Phone (207) 630-2922

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
R.I.S.E. Integrated Mental Health PLLC 7 clinicians

Practice addresses (Care Compare)

4 Market Place Dr
Suite 1 2
York, ME 03909-1698
Phone (207) 630-2922

NPI Registry JSON

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

{
    "created_epoch": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364428800000",
    "number": "1104076702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 STEVENS RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214115",
            "telephone_number": "617-866-9327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STEVENS RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024214115",
            "telephone_number": "617-866-9327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WERT",
        "first_name": "MOLLY",
        "middle_name": "S",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2013-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "S65948197",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, MA

Sources for this page

Verify at the official NPI Registry.