MS. ELISABETH VAN DER KOLK L.I.C.S.W.
NPI 1487773404
Social Worker - Clinical in Watertown, MA

Active since March 29, 2007
23 MAIN ST, WATERTOWN, MA 02472(617) 312-4116 Get Directions Write a Review

NPPES record last updated: July 24, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Elisabeth Van Der Kolk L.i.c.s.w. NPPES

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

MS. ELISABETH VAN DER KOLK L.I.C.S.W. (NPI 1487773404) is an individual clinical provider in Watertown, Massachusetts, licensed in Massachusetts (102645) and active in the NPI registry since March 2007.

NPPES Registry Identity

NPI1487773404
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameMS. ELISABETH VAN DER KOLKCredential: L.I.C.S.W.
Location Address23 MAIN STWatertown, MA 02472-4403
Mailing Address156 Green Street #301Jamaica Plain, MA 02130 · (617) 312-4116 · Fax (617) 942-2041
Sole ProprietorNo
Enumeration DateMarch 29, 2007
Last NPPES UpdateJuly 24, 2013
NPI 1487773404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in MA · 102645
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.
23 MAIN ST, Watertown, MA 02472

Other Identifiers 3

Medicare ID-Type UnspecifiedP21941MA · Medicare
Other459408MA · Tufts Health Plan
OtherVAP03254MA · Blue Cross Blue Shield

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
23 MAIN ST, 2ND FLOOR
WATERTOWN, MA 02472
Community/Behavioral Health
23 MAIN ST
WATERTOWN, MA 02472
Clinic/Center (Adolescent and Children Mental Health)
23 MAIN ST
WATERTOWN, MA 02472
Social Worker (Clinical)
23 MAIN ST, CTR INTEGRATIVE HEALING 2ND FLOOR
WATERTOWN, MA 02472
Counselor (Mental Health)
23 MAIN ST
WATERTOWN, MA 02472
Counselor (Mental Health)
23 MAIN ST
WATERTOWN, MA 02472
Counselor (Mental Health)
23 MAIN ST
WATERTOWN, MA 02472
Counselor (Mental Health)
23 MAIN ST
WATERTOWN, MA 02472

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 Elisabeth Van Der Kolk's NPI number?

The NPI number for Elisabeth Van Der Kolk is 1487773404. It was assigned to this individual provider in the NPPES registry on March 29, 2007.

Where is Elisabeth Van Der Kolk located?

Elisabeth Van Der Kolk practices at 23 Main St, Watertown, MA 02472. The listed phone number is (617) 312-4116.

What is Elisabeth Van Der Kolk's specialty?

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

When was this NPI record last updated?

The NPPES record for Elisabeth Van Der Kolk was last updated on July 24, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.