Wallace William Varonko, PHD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

4573 Issued in MA

Practice address

30 Taunton Greene Suite 5
Taunton, MA 02780

Phone

(508) 880-6666

Fax

(508) 880-6655

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Specialty

Clinical Psychologist

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Northeast Health Services, LLC

  dba Hyland Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Taunton, MA
  • NPI 1225067481
  Medicare reassignment Care Compare group NPD Authorized official
• Bridgewater Pediatrics LLC

  • Pediatrics Physician
  • Bridgewater, MA
  • NPI 1255579975
  NPD (past)
• Northeast Health Services

  • Community/Behavioral Health Agency
  • Taunton, MA
  • NPI 1730525163
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1003916313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78 BOLAS ROAD",
            "city": "DUXBURY",
            "state": "MA",
            "postal_code": "02332",
            "telephone_number": "781-582-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 TAUNTON GREENE SUITE 5",
            "city": "TAUNTON",
            "state": "MA",
            "postal_code": "02780",
            "telephone_number": "508-880-6666",
            "fax_number": "508-880-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARONKO",
        "first_name": "WALLACE",
        "middle_name": "WILLIAM",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "4573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1311778",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary-Anne Hope Usdan, MSW LICSW
• Rebecca Uth, PSYD
• Katrina Marie Vallee
• Emma Vargas, DPT
• Jessica Karen Varley
• Gabriela Velcea, M.D.
• Elizabeth Venuti, LCSW
• Alison Verdone, NP
• Patricia Vernal
• Victory Distributors LLC

• Counseling Psychologist in Taunton, MA
• Providers in Taunton, MA by specialty
• Counseling Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.