Provider Demographics
NPI:1942478417
Name:VAN DER VEEN, SARAH MADELINE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:MADELINE
Last Name:VAN DER VEEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:SARAH
Other - Middle Name:MADELINE
Other - Last Name:VAN DER VEEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:90 PINE ST
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02332-4102
Mailing Address - Country:US
Mailing Address - Phone:781-585-5922
Mailing Address - Fax:
Practice Address - Street 1:90 PINE ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4102
Practice Address - Country:US
Practice Address - Phone:781-585-5922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10248441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical