Active NPI
Joseph C Vandyck, LCSW
- Clinical Social Worker
- Smyrna, GA
National Provider Identifier
1568841005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW005458
- Practice address
- 3188 Atlanta Serd
Smyrna, GA 30080-8256 - Phone
- (404) 337-1331
- Fax
- (770) 319-6330
- NPI assigned
- May 28, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW005458 | GA | Primary |
Addresses
Primary practice location
3188 Atlanta Serd
Smyrna, GA 30080-8256
Mailing address
217 Ridgeland Ave
Decatur, GA 30030-2057
Phone (404) 337-1331
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW005458 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449446400000",
"number": "1568841005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "217 RIDGELAND AVE",
"city": "DECATUR",
"state": "GA",
"postal_code": "300302057",
"telephone_number": "404-337-1331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3188 ATLANTA SERD",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300808256",
"telephone_number": "404-337-1331",
"fax_number": "770-319-6330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYCK",
"first_name": "JOSEPH",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-28",
"last_updated": "2015-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW005458",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smyrna, GA
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- Suzanne Civille Urquhart, M.ED, CCC-SLP
- Rosa C Urrutia, MD
- Valentine Medical Solutions,LLC
- Reena Vanmali, M.D.
- Faye Vargas Morris, M.D.
- Suny Varughese, NP
- Bijal Vashi, M.D.
- Kathryn Miles Vasquez, M.S., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.