Katie Anne Van Leeuwen, MSW, LICSW

Individual provider Active NPI Clinical Social Worker · Barnstable, MA

NPI 1700932183 · NPPES record last updated Feb 26, 2016

Key facts

NPI
1700932183
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
116412 (MA)
Practice address
3195 Main Street
Barnstable, MA 02630
Phone
(508) 362-8606
Fax
(508) 362-0046
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
992321COMDMental Health Counselor
116412MAMDChild & Adolescent Psychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 992321 CO
Clinical Social Worker 1041C0700X 116412 MA Yes

Addresses

Primary practice location

3195 Main Street
Barnstable, MA 02630

Mailing address

3195 Main Street, P.O. Box 427
Barnstable, MA 02630
Phone (508) 362-8606

Other providers in Barnstable, MA

All providers in Barnstable, MA · Clinical Social Worker in Massachusetts

Sources for this page

Verify at the official NPI Registry.