MEDICARE: VAN DER BURG PSYCHIATRIC SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1871421008
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VAN DER BURG PSYCHIATRIC SERVICES PLLC

Provider Business Mailing Address
First Line	:	PO BOX 215
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-0215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 LYNDE ST
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-3404
Country	:	US
Telephone Number	:	339-927-1135
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANNE-TERESE VAN DER BURG
Credential	:	NP
Telephone Number	:	617-208-4239

Provider Enumeration Date	:	05/09/2026
Last Update Date	:	05/11/2026

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