Individual provider Active NPI

Wendy Vedrine, LMHC

  • Mental Health Counselor
  • Pawtucket, RI
National Provider Identifier
1073038949
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MHC01133 Issued in RI
Practice address
126 Prospect St Ste 206
Pawtucket, RI 02860-4476
Phone
(401) 400-2135
NPI assigned
Aug 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MHC01133 RI Primary

Addresses

Primary practice location

126 Prospect St Ste 206
Pawtucket, RI 02860-4476

Mailing address

40 Dix Ave
Johnston, RI 02919-4851
Phone (404) 903-5840

Other practice location 1

35 Summer St
Taunton, MA 02780-3469
Phone (508) 930-2361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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

Enrollment IDStateProvider typePAC IDDetails
I20240112000555 RI Practitioner - Mental Health Counselor 4486005683 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gateway Healthcare IncGroup PAC ID 7719874908, 66 clinicians

Practice addresses (Care Compare)

1443 Hartford Ave
Johnston, RI 02919-3224
Phone (401) 273-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MHC01133RIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wendy V., LMHC, LLC Mental Health CurrentSince Oct 25, 2020 Accepting new patients
Gateway Healthcare Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

126 Prospect St
Ste 206
Pawtucket, RI 02860
Phone (401) 400-2135

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

1 Virginia Ave
Ste 200
Providence, RI 02905

1 Richmond Sq
Ste 321W
Providence, RI 02906
Phone (401) 400-0944

1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1502409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684108800000",
    "number": "1073038949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 DIX AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194851",
            "telephone_number": "404-903-5840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 PROSPECT ST STE 206",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604476",
            "telephone_number": "401-400-2135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Summer St",
            "address_purpose": "LOCATION",
            "city": "Taunton",
            "state": "MA",
            "postal_code": "027803469",
            "country_code": "US",
            "telephone_number": "508-930-2361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEDRINE",
        "first_name": "WENDY",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-11",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "RI",
            "license": "MHC01133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.