S. Van Derwood, Licensed Clinical Social Worker, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

S. VAN DERWOOD, LICENSED CLINICAL SOCIAL WORKER, INC

Practice address

5170 Golden Foothill Pkwy
El Dorado Hills, CA 95762-9608

Phone

(916) 597-0284

NPI assigned

Jun 4, 2021

Last updated

Jun 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sharon Lynn Van Derwood, LCSWNPI 1851413272

Title

Psychotherapist

Phone

(916) 597-0284

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sharon Lynn Van Derwood, LCSW

  • Clinical Social Worker
  • El Dorado Hills, CA
  • NPI 1851413272
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1622764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1508433954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629608",
            "telephone_number": "916-597-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 GOLDEN FOOTHILL PKWY",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629608",
            "telephone_number": "916-597-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. VAN DERWOOD, LICENSED CLINICAL SOCIAL WORKER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-04",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "VAN DERWOOD",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "916-597-0284",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sussan Saboor, M.D
• Sacramento Addiction Rehab LLC

• Community/Behavioral Health Agency in El Dorado Hills, CA
• Providers in El Dorado Hills, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.