Abbie Marie Vander Maten, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

21765 Issued in MN

Practice address

6120 Earle Brown Dr Ste 520
Brooklyn Center, MN 55430-4112

Phone

(763) 531-0566

NPI assigned

Jun 4, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Wild Tree Psychotherapy, LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1528451408
  Medicare reassignment NPD
• Sarah C. Chambers, P.a.

  • Health Service Clinic/Center
  • Saint Paul, MN
  • NPI 1942358379
  NPD (past)

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1992329965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 EARLE BROWN DR STE 520",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554304112",
            "telephone_number": "763-531-0566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 EARLE BROWN DR STE 520",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554304112",
            "telephone_number": "763-531-0566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER MATEN",
        "first_name": "ABBIE",
        "middle_name": "MARIE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "21765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valens Health LLC
• Patricia Louise Van de Veer, LPC, LPCC
• Brooke Van Dyke
• Alyssa Van Klei
• Vancoop Corporation
• Anita Vang, OTD, OTR/L
• Bao Vang
• Betty Vang
• Kovy Vang
• Mai Zong Vang

• Clinical Social Worker in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.