Active NPI
Heidi Vega Cavanaugh, LICSW
- Clinical Social Worker
- Salem, MA
National Provider Identifier
1215411632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 118957
- Practice address
- 19 Bryant St Apt 1
Salem, MA 01970-2330 - Phone
- (617) 543-3792
- NPI assigned
- Sep 21, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 118957 | MA | Primary |
Addresses
Primary practice location
19 Bryant St Apt 1
Salem, MA 01970-2330
Mailing address
19 Bryant St Apt 1
Salem, MA 01970-2330
Phone (617) 543-3792
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Aug 11, 2022 through Aug 11, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 118957 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594166400000",
"number": "1215411632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 BRYANT ST APT 1",
"city": "SALEM",
"state": "MA",
"postal_code": "019702330",
"telephone_number": "617-543-3792",
"fax_number": "978-491-6573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 BRYANT ST APT 1",
"city": "SALEM",
"state": "MA",
"postal_code": "019702330",
"telephone_number": "617-543-3792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAUGH",
"first_name": "HEIDI",
"middle_name": "VEGA",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-21",
"last_updated": "2020-07-08",
"certification_date": "2020-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "118957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.