Active NPI
Megan Anne Vandenberg, MSW, LICSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1982197810
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 121024
- Practice address
- 15 Parkman Street Wac 037
Social Service Department
Boston, MA 02114 - Phone
- (617) 724-5258
- NPI assigned
- Jun 14, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 121024 | MA | Primary |
Addresses
Primary practice location
15 Parkman Street Wac 037
Social Service Department
Boston, MA 02114
Mailing address
15 Parkman Street Wac 037
Social Service Department
Boston, MA 02114
Phone (617) 724-5258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121024 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528934400000",
"number": "1982197810",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 PARKMAN STREET WAC 037",
"address_2": "SOCIAL SERVICE DEPARTMENT",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-724-5258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PARKMAN STREET WAC 037",
"address_2": "SOCIAL SERVICE DEPARTMENT",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-724-5258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBERG",
"first_name": "MEGAN",
"middle_name": "ANNE",
"credential": "MSW, LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-06-14",
"last_updated": "2018-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "121024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.