Individual provider Active NPI

Austyn West Van Der Linden, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1972067270
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17771 Issued in FL
Practice address
2354 Christopher PL
Tallahassee, FL 32308-4109
Phone
(850) 510-8778
Fax
(850) 668-8047
NPI assigned
Jan 31, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 SW17771 FL Primary

Addresses

Primary practice location

2354 Christopher PL
Tallahassee, FL 32308-4109

Mailing address

2354 Christopher PL
Tallahassee, FL 32308-4109
Phone (850) 510-8778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240306002305 FL Practitioner - Clinical Social Worker 4981040540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2354 Christopher PL
Tallahassee, FL 32308-4109
Phone (850) 296-8982

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Counseling & Consulting Clinical CurrentSince Mar 1, 2024 Accepting new patients

Locations

2354 Christopher Pl
Tallahassee, FL 32308
Phone (850) 296-8982

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": "1548892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1972067270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2354 CHRISTOPHER PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084109",
            "telephone_number": "850-510-8778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2354 CHRISTOPHER PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084109",
            "telephone_number": "850-510-8778",
            "fax_number": "850-668-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER LINDEN",
        "first_name": "AUSTYN",
        "middle_name": "WEST",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-31",
        "last_updated": "2023-05-10",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.