Jan Pieter Struyde, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

220570 Issued in MA

Practice address

2 Edge St
Ipswich, MA 01938-1110

Phone

(781) 631-2850

NPI assigned

Mar 28, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1831465418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EDGE ST",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019381110",
            "telephone_number": "781-631-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EDGE ST",
            "city": "IPSWICH",
            "state": "MA",
            "postal_code": "019381110",
            "telephone_number": "781-631-2850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STRUYDE",
        "first_name": "JAN",
        "middle_name": "PIETER",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-28",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "220570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026265",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ipswich, MA
• Providers in Ipswich, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.