Individual provider Active NPI

Sarah Elizabeth Teeven, LICSW

  • Clinical Social Worker
  • Waltham, MA
National Provider Identifier
1578035721
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113286 Issued in MA
Practice address
17 Linden Park Dr
Waltham, MA 02452-6216
Phone
(617) 680-4367
NPI assigned
Dec 28, 2018
Last updated
Dec 28, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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 113286 MA Primary

Addresses

Primary practice location

17 Linden Park Dr
Waltham, MA 02452-6216

Mailing address

17 Linden Park Dr
Waltham, MA 02452-6216
Phone (617) 680-4367

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
113286MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1578035721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LINDEN PARK DR",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024526216",
            "telephone_number": "617-680-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LINDEN PARK DR",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024526216",
            "telephone_number": "617-680-4367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEEVEN",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; 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.