Individual provider Active NPI

Andrea P Vana, LCSW

  • Clinical Social Worker
  • Roslindale, MA
National Provider Identifier
1871817049
Registry record updated Dec 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
220342 Issued in MA
Practice address
780 American Legion Hwy
Roslindale, MA 02131-3908
Phone
(617) 469-8500
NPI assigned
Mar 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 220342 MA Primary

Addresses

Primary practice location

780 American Legion Hwy
Roslindale, MA 02131-3908

Mailing address

125 Browne St # 2
Brookline, MA 02446-7007
Phone (978) 399-8564

Other names 1

  • Andrea L Patrikis Former name

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
I20190918001158 MA Practitioner - Clinical Social Worker 5698005635 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
220342MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eliot Community Human Services CurrentSince Aug 5, 2019 Accepting new patients
Eliot Community Human Services CurrentSince Aug 5, 2019 Accepting new patients

Locations

86 Baker Avenue Ext
Ste 100
Concord, MA 01742
Phone (978) 202-4156

125 Hartwell Ave
Lexington, MA 02421
Phone (781) 734-2060

Organizations & group practices 2

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": "1268784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418256000000",
    "number": "1871817049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 BROWNE ST # 2",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024467007",
            "telephone_number": "978-399-8564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "617-469-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANA",
        "first_name": "ANDREA",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-17",
        "last_updated": "2014-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "220342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "PATRIKIS",
            "middle_name": "L",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.