Individual provider Active NPI

Diana Lavancher, LICSW

  • Clinical Social Worker
  • Woburn, MA
National Provider Identifier
1982012076
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
113033 Issued in MA
Practice address
500 W Cummings Park
Suite 3900
Woburn, MA 01801-6503
Phone
(781) 932-8114
Fax
(781) 932-0218
NPI assigned
Aug 1, 2014
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 113033 MA Primary

Addresses

Primary practice location

500 W Cummings Park
Suite 3900
Woburn, MA 01801-6503

Mailing address

500 W Cummings Park
Suite 3900
Woburn, MA 01801-6503
Phone (781) 932-8114

Other practice location 1

41 Mall Rd
Burlington, MA 01805-6503
Phone (781) 744-8000

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
I20140904000525 MA Practitioner - Clinical Social Worker 9133347164 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians
Beth Israel Lahey Health Specialty Care, Inc.Group PAC ID 2365405024, 264 clinicians

Practice addresses (Care Compare)

199 Rosewood Dr
Suite 300
Danvers, MA 01923-1388
Phone (978) 494-8163

41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923-4065
Phone (978) 304-8451

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
113033MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Mar 1, 2023 Accepting new patients
Northeast Health Services, LLC CurrentSince May 26, 2023 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

199 Rosewood Dr
Ste 300
Danvers, MA 01923
Phone (978) 291-7066

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1982012076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK",
            "address_2": "SUITE 3900",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016503",
            "telephone_number": "781-932-8114",
            "fax_number": "781-932-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W CUMMINGS PARK",
            "address_2": "SUITE 3900",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016503",
            "telephone_number": "781-932-8114",
            "fax_number": "781-932-0218"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018056503",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVANCHER",
        "first_name": "DIANA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-01",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.