Jonikka Elizabeth Vance, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34004954A Issued in IN

Practice address

1315 Hillcrest Rd
Bedford, IN 47421-3023

Phone

(812) 279-3591

Fax

(812) 275-0787

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD
• Southern Hills Counseling Center, Inc.

  • Clinical Psychologist
  • Jasper, IN
  • NPI 1134118276
  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1043303514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S ROGERS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "telephone_number": "812-339-1691",
            "fax_number": "812-337-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 HILLCREST RD",
            "city": "BEDFORD",
            "state": "IN",
            "postal_code": "474213023",
            "telephone_number": "812-279-3591",
            "fax_number": "812-275-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JONIKKA",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004954A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristal Lagail Trotter, CRNA
• Michelle Tucci, PT
• Chad Umphress, COTA
• Union Optical and Eyecare Center, Inc. (Eyeconic Eyecare)
• Ashton E Valentine, RBT
• Pekkuzhiyil Anthrayose Varghese, MD
• Shaina Faith Voorhies, PTA
• Georgi Wade, BS
• Wal-Mart Stores East LP (Walmart Pharmacy 10-1026)
• Wal-Mart Stores, Inc. (Vision Center 30-1026)

• Clinical Social Worker in Bedford, IN
• Providers in Bedford, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.