Kristin Maddox Vandenbussche, LCSW-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P008299 Issued in NC

Practice address

2245 Stantonsburg Rd
Ste O
Greenville, NC 27834-2868

Phone

(252) 752-0483

Fax

(252) 757-3172

NPI assigned

Aug 8, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1375920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1629400981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SAPPHIRE CT STE 110",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278349079",
            "telephone_number": "252-830-7540",
            "fax_number": "252-752-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 STANTONSBURG RD",
            "address_2": "STE O",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342868",
            "telephone_number": "252-752-0483",
            "fax_number": "252-757-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBUSSCHE",
        "first_name": "KRISTIN",
        "middle_name": "MADDOX",
        "credential": "LCSW-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-08",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P008299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Christina Van Wyk, MD
• Rustan Joel Van Wyk, D.O.
• Chelsea Lynn Vanaken, DO
• Laila Vance
• Andrew James Vande Berg, ATC
• Joel Leonard Vanderford
• Andrew Schuil Vanderveer, M.D.
• Victoria Vang
• Richard Vantienderen, DO
• Maryann L Vanvoorhees, CRNA

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; 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.