Individual provider Active NPI

Sarah Madeline Van Der Veen, LICSW

  • Clinical Social Worker
  • Duxbury, MA
National Provider Identifier
1942478417
Registry record updated Feb 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1024844 Issued in MA
Practice address
90 Pine St
Duxbury, MA 02332-4102
Phone
(781) 585-5922
NPI assigned
Feb 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2008

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 1024844 MA Primary

Addresses

Primary practice location

90 Pine St
Duxbury, MA 02332-4102

Mailing address

90 Pine St
Duxbury, MA 02332-4102
Phone (781) 585-5922

Other names 1

  • Mrs. Sarah Madeline Van Der Veen Professional 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
I20140114000415 MA Practitioner - Clinical Social Worker 0244468577 Reassigns benefits to 2 organizations
Practice locations: Plymouth, MA; Kingston, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians

Practice addresses (Care Compare)

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. CurrentSince Sep 23, 2013 Accepting new patients

Locations

1501 Washington St
Braintree, MA 02184
Phone (617) 745-2709

Interoperability endpoints

  • Direct secure messaging: svanderveen456543@direct.bilh.masshiway.net

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": "1203292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1942478417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PINE ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324102",
            "telephone_number": "781-585-5922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PINE ST",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "023324102",
            "telephone_number": "781-585-5922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER VEEN",
        "first_name": "SARAH",
        "middle_name": "MADELINE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-18",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1024844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "VAN DER VEEN",
            "middle_name": "MADELINE",
            "prefix": "MRS.",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Duxbury, MA

Sources for this page

Verify at the official NPI Registry.