Individual provider Active NPI

Angela E Vang, LCSW

  • Clinical Social Worker
  • Somerville, MA
National Provider Identifier
1669594784
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
214337 Issued in MA
Practice address
63 College Ave
Somerville, MA 02144-1957
Phone
(617) 629-6628
Fax
(617) 629-4454
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 214337 MA Primary

Addresses

Primary practice location

63 College Ave
Somerville, MA 02144-1957

Mailing address

11 Park Street CT
Medford, MA 02155-3902
Phone (617) 512-7003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081211000228 MA Practitioner - Clinical Social Worker 2860553682 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

402 A Highland Ave
F
Somerville, MA 02144-2511
Phone (857) 321-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
214337MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Angela Vang, Psychotherapy LLC Clinical CurrentSince Jul 1, 2014 Accepting new patients
Riverside Community Care, Inc. Past Accepting new patients
Somerville Mental Health Association, Inc. Past Accepting new patients

Locations

402A Highland Ave
#F
Somerville, MA 02144
Phone (857) 321-3400

Organizations & group practices 3

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669594784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PARK STREET CT",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021553902",
            "telephone_number": "617-512-7003",
            "fax_number": "617-629-4454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 COLLEGE AVE",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021441957",
            "telephone_number": "617-629-6628",
            "fax_number": "617-629-4454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "ANGELA",
        "middle_name": "E",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "214337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.