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MR. JAN-KEES GEORGE VAN DER GAAG MSW, LCSW
NPI 1093970378
Social Worker - Clinical in Los Angeles, CA

Active since July 25, 2008Opted out of Medicare · through Nov 13, 2027
2630 HOLLYRIDGE DRIVE, LOS ANGELES, CA 90068(323) 487-1784(310) 423-7169 Get Directions Write a Review

NPPES record last updated: July 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 5, 2022, Jun 16, 2021 (2 updates tracked since 2021).

About Mr. Jan-kees George Van Der Gaag Msw, Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JAN-KEES GEORGE VAN DER GAAG MSW, LCSW (NPI 1093970378) is an individual clinical provider in Los Angeles, California, licensed in California (LCSW23674) and active in the NPI registry since July 2008. He has opted out of Medicare through November 13, 2027.

NPPES Registry Identity

NPI1093970378
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JAN-KEES GEORGE VAN DER GAAGCredential: MSW, LCSW
Location Address2630 HOLLYRIDGE DRIVELos Angeles, CA 90068
Mailing Address2630 Hollyridge DriveLos Angeles, CA 90068 · (323) 487-1784 · Fax (310) 423-7169
Phone(323) 487-1784
Fax(310) 423-7169
Sole ProprietorNo
Enumeration DateJuly 25, 2008
Last NPPES UpdateJuly 5, 20222 updates tracked since enumeration
NPPES CertifiedJuly 5, 2022
✔ NPI 1093970378 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in CA · LCSW23674✔ Licensed in CA · LCS23674
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2630 HOLLYRIDGE DRIVE, Los Angeles, CA 90068
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Jan-kees George Van Der Gaag Msw, Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 13, 2023 through November 13, 2027.

Opt-Out Effective DateNovember 13, 2023
Opt-Out In Effect ThroughNovember 13, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jan-kees Van Der Gaag's NPI number?

The NPI number for Jan-kees Van Der Gaag is 1093970378. It was assigned to this individual provider in the NPPES registry on July 25, 2008.

Where is Jan-kees Van Der Gaag located?

Jan-kees Van Der Gaag practices at 2630 Hollyridge Drive, Los Angeles, CA 90068. The listed phone number is (323) 487-1784.

What is Jan-kees Van Der Gaag's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Jan-kees Van Der Gaag enrolled in Medicare?

No. Jan-kees Van Der Gaag has opted out of Medicare through November 13, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jan-kees Van Der Gaag was last updated on July 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.