Individual provider Active NPI

Bethany M. Hadvab, LCSW

  • Clinical Social Worker
  • Walpole, MA
National Provider Identifier
1710294293
Registry record updated Sep 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
216232 Issued in MA
Practice address
409 Lincoln Rd
Walpole, MA 02081-1217
Phone
(508) 668-7703
Fax
(508) 660-9639
NPI assigned
Sep 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2010

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 216232 MA Primary

Addresses

Primary practice location

409 Lincoln Rd
Walpole, MA 02081-1217

Mailing address

968 Main St
Apt. 9
Walpole, MA 02081-2835
Phone (860) 810-6442

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
216232MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elemental Intuition LLC Clinical Past Accepting new patients

Organizations & group practices 1

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": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283817600000",
    "number": "1710294293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "968 MAIN ST",
            "address_2": "APT. 9",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020812835",
            "telephone_number": "860-810-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 LINCOLN RD",
            "city": "WALPOLE",
            "state": "MA",
            "postal_code": "020811217",
            "telephone_number": "508-668-7703",
            "fax_number": "508-660-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADVAB",
        "first_name": "BETHANY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2010-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "216232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walpole, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2010; 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.