Individual provider Active NPI

Rachel Van Zevenbergen, LCSW

  • Social Worker
  • Deerfield, IL
National Provider Identifier
1285046334
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150014231 Issued in IL
Practice address
1669 Lake Eleanor Dr
Deerfield, IL 60015-2052
Phone
(224) 338-6059
NPI assigned
May 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150014231 IL Primary

Addresses

Primary practice location

1669 Lake Eleanor Dr
Deerfield, IL 60015-2052

Mailing address

1669 Lake Eleanor Dr
Deerfield, IL 60015-2052
Phone (224) 338-6059

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
150014231ILMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Space Therapy, PLLC Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1285046334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1669 LAKE ELEANOR DR",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152052",
            "telephone_number": "224-338-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1669 LAKE ELEANOR DR",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600152052",
            "telephone_number": "224-338-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN ZEVENBERGEN",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-23",
        "last_updated": "2022-06-28",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150014231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.