Jillian Vandenberg, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801089375 Issued in IN

Practice address

403 E Madison St
South Bend, IN 46617-2322

Phone

(574) 283-1107

Fax

(574) 283-1131

NPI assigned

Feb 29, 2008

Sex

Female

Sole proprietor

No

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204243200000",
    "number": "1184893539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19506 BROWNSVILLE RD",
            "city": "CASSOPOLIS",
            "state": "MI",
            "postal_code": "490318569",
            "telephone_number": "574-283-1107",
            "fax_number": "574-283-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 E MADISON ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172322",
            "telephone_number": "574-283-1107",
            "fax_number": "574-283-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "JILLIAN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-29",
        "last_updated": "2008-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "6801089375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keri Van Acker
• Ester P J Van Der Wal, MD
• James Alan Van Fleit, O.D.
• Jennifer Ann Vance, COTA
• Kimberly Sue Vance, MASTER OF EDUCATION
• Thomas R Vanderheyden Jr., D.O.
• Evert M Vanderstoep, M.D.
• John Michael Vanhulle, RPH
• Kaitlyn Nicole Vanriper, MD
• Allison Anne Vansickle, BS-SLP

• Social Worker in South Bend, IN
• Providers in South Bend, IN by specialty
• Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; 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.