Susan H Webster Van Drie, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

110808 Issued in MA

Practice address

99 Church St
Lowell, MA 01852-2621

Phone

(978) 458-6282

Fax

(978) 441-9826

NPI assigned

Sep 15, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2017 through Oct 1, 2027

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1598098121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 STINSON RD",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018105012",
            "telephone_number": "978-470-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CHURCH ST",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018522621",
            "telephone_number": "978-458-6282",
            "fax_number": "978-441-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER VAN DRIE",
        "first_name": "SUSAN",
        "middle_name": "H",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110808",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1305638",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Wauford, LCSW
• Derek Dean Wayman
• Grayson Dorian Wayne, MSW, LCSW
• Yari Weaver, M.ED
• April Lynn Webb
• Richard Erick Webster
• Beatrice Sun Wei
• Jerold M Weiner, M.D.
• Harold Weintraub, MD
• Kim Ellen Weisensee, SLP

• Clinical Social Worker in Lowell, MA
• Providers in Lowell, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.