Jennifer Ann Vlacovsky, MSW, LICSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

113408 Issued in MA

Practice address

40 Fairbank Rd Ste C
Sudbury, MA 01776-5609

Phone

(978) 639-3208

NPI assigned

May 7, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Ann Ladner Former name

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": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1215426135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FAIRBANK RD STE C",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017765609",
            "telephone_number": "978-639-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 FAIRBANK RD STE C",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "017765609",
            "telephone_number": "978-639-3208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLACOVSKY",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-07",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MA",
            "license": "113408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW (SOCIAL WORK LICENSE)",
            "identifier": "113408",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "LADNER",
            "middle_name": "ANN",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• School Social Worker in Sudbury, MA
• Providers in Sudbury, MA by specialty
• School Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; 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.