Eugene Vanburch

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

089453-1 Issued in NY

Practice address

9701 Apollo Dr Ste 100
Largo, MD 20774-4785

Phone

(301) 851-9965

NPI assigned

Aug 1, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1124450051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 GARRETT A MORGAN BLVD",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207854510",
            "telephone_number": "301-851-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 APOLLO DR STE 100",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207744785",
            "telephone_number": "301-851-9965"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "912 Main St",
            "address_purpose": "LOCATION",
            "city": "Stroudsburg",
            "state": "PA",
            "postal_code": "183601641",
            "country_code": "US",
            "telephone_number": "570-629-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANBURCH",
        "first_name": "EUGENE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-01",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089453-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Largo, MD
• Providers in Largo, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.