Individual provider Active NPI

Rachel Elizabeth Johnston Vanoverbeke, LICSW

  • Clinical Social Worker
  • Hopkins, MN
National Provider Identifier
1710418215
Registry record updated Mar 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22803 Issued in MN
Practice address
424 Harrison Ave S
Hopkins, MN 55343-8418
Phone
(507) 380-5539
NPI assigned
Mar 26, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2017

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 22803 MN Primary

Addresses

Primary practice location

424 Harrison Ave S
Hopkins, MN 55343-8418

Mailing address

424 Harrison Ave S
Hopkins, MN 55343-8418
Phone (507) 380-5539

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
22803MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490486400000",
    "number": "1710418215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "424 HARRISON AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438418",
            "telephone_number": "507-380-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 HARRISON AVE S",
            "city": "HOPKINS",
            "state": "MN",
            "postal_code": "553438418",
            "telephone_number": "507-380-5539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOVERBEKE",
        "first_name": "RACHEL",
        "middle_name": "ELIZABETH JOHNSTON",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-26",
        "last_updated": "2017-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkins, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2017; 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.