Individual provider Active NPI

Yvonne Dejean

  • Clinical Social Worker
  • Brockton, MA
National Provider Identifier
1508593724
Registry record updated Apr 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
227863 Issued in MA
Practice address
77 Fairbanks Rd
Brockton, MA 02302-4507
Phone
(617) 752-1855
NPI assigned
Aug 7, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 227863 MA Primary

Addresses

Primary practice location

77 Fairbanks Rd
Brockton, MA 02302-4507

Mailing address

2 Abbot Mill LN Apt 11-8
Westford, MA 01886-1668
Phone (617) 752-1855

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Wellness Institute, LLC Clinical CurrentSince Mar 20, 2025 Accepting new patients
Rooted Counseling Services, LLC Clinical CurrentSince Aug 14, 2022 Accepting new patients

Organizations & group practices 2

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": "1659830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777420800000",
    "number": "1508593724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 ABBOT MILL LN APT 11-8",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018861668",
            "telephone_number": "617-752-1855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 FAIRBANKS RD",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023024507",
            "telephone_number": "617-752-1855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJEAN",
        "first_name": "YVONNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-07",
        "last_updated": "2026-04-29",
        "certification_date": "2026-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "227863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2026; 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.