Individual provider Active NPI

Vanessa F Vanon, LICSW

  • Clinical Social Worker
  • Roslindale, MA
National Provider Identifier
1871941096
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
123589 Issued in MA
Practice address
780 American Legion Hwy
Roslindale, MA 02131-3908
Phone
(617) 469-8680
NPI assigned
May 27, 2016
Last updated
May 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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 123589 MA Primary

Addresses

Primary practice location

780 American Legion Hwy
Roslindale, MA 02131-3908

Mailing address

780 American Legion Hwy
Roslindale, MA 02131-3908
Phone (617) 469-8680

Other practice location 1

700 Massachusetts Ave Fl 3
Cambridge, MA 02139-3345
Phone (888) 500-2067

Other identifiers 1

IdentifierTypeStateIssuer
101014MedicaidMA

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
I20260525000573 MA Practitioner - Clinical Social Worker 2961972559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

700 Massachusetts Ave
FL 3
Cambridge, MA 02139-3345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
123589MAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1871941096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 AMERICAN LEGION HWY",
            "city": "ROSLINDALE",
            "state": "MA",
            "postal_code": "021313908",
            "telephone_number": "617-469-8680"
        },
        {
            "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": "617-469-8680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 Massachusetts Ave Fl 3",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021393345",
            "country_code": "US",
            "telephone_number": "888-500-2067",
            "fax_number": "617-649-8520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANON",
        "first_name": "VANESSA",
        "middle_name": "F",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "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": "123589",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101014",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roslindale, MA

Sources for this page

Verify at the official NPI Registry.