Individual provider Active NPI

Vicki Laversa, LADC, ICADC, CADC-II

  • Addiction (Substance Use Disorder) Counselor
  • Carson City, NV
National Provider Identifier
1104253293
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
00978 Issued in NV
Practice address
1802 N Carson St
#155
Carson City, NV 89701-1265
Phone
(775) 235-8730
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00978 NV Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 710216
Addiction (Substance Use Disorder) Counselor 101YA0400X A7590312

Addresses

Primary practice location

1802 N Carson St
#155
Carson City, NV 89701-1265

Mailing address

PO Box 2495
Carson City, NV 89702-2495
Phone (775) 220-2751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00978NVMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380758400000",
    "number": "1104253293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2495",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897022495",
            "telephone_number": "775-220-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 N CARSON ST",
            "address_2": "#155",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897011265",
            "telephone_number": "775-235-8730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVERSA",
        "first_name": "VICKI",
        "credential": "LADC, ICADC, CADC-II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "00978",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "710216",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": "A7590312",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.