Individual provider Active NPI

Jane Dreeben, PH.D., L.A.D.C. I

  • Addiction (Substance Use Disorder) Psychologist
  • Vineyard Haven, MA
National Provider Identifier
1265500508
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X
License
415 Issued in MA
Practice address
15 Church St.
Vineyard Haven, MA 02568
Phone
(508) 693-5523
Fax
(508) 696-8619
NPI assigned
Dec 4, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6648 MA
Addiction (Substance Use Disorder) Psychologist 103TA0400X 415 MA Primary

Addresses

Primary practice location

15 Church St.
Vineyard Haven, MA 02568

Mailing address

PO Box 516
West Tisbury, MA 02575-0516
Phone (508) 693-5523

Other identifiers 1

IdentifierTypeStateIssuer
W05885OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040317000671 MA Practitioner - Clinical Psychologist 9234029950 Practice locations: Hadley, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

36 Greenleaves Dr
Apt 40
Hadley, MA 01035-3544
Phone (508) 693-5523

36 Greenleaves Dr Unit
Suite 40
Hadley, MA 01035-3544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
415MAMDAthletic Trainer
6648MAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1265500508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "WEST TISBURY",
            "state": "MA",
            "postal_code": "025750516",
            "telephone_number": "508-693-5523",
            "fax_number": "508-696-8619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CHURCH ST.",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "02568",
            "telephone_number": "508-693-5523",
            "fax_number": "508-696-8619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREEBEN",
        "first_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.A.D.C. I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "6648",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "W05885",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineyard Haven, MA

Sources for this page

Verify at the official NPI Registry.