Liberti E Vegas

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.2107143 Issued in OH

Practice address

1129 Miamisburg Centerville Rd Ste 202
West Carrollton, OH 45449-4008

Phone

(216) 659-6986

NPI assigned

Feb 12, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Decoach Team LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cincinnati, OH
  • NPI 1366992224
  NPD
• Decoach Team LLC

  • Adult Mental Health Clinic/Center
  • Cincinnati, OH
  • NPI 1578037552
  NPD (past)

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

{
    "created_epoch": "1581465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1114559671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1129 MIAMISBURG CENTERVILLE RD",
            "city": "WEST CARROLLTON",
            "state": "OH",
            "postal_code": "454494004",
            "telephone_number": "937-776-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 MIAMISBURG CENTERVILLE RD STE 202",
            "city": "WEST CARROLLTON",
            "state": "OH",
            "postal_code": "454494008",
            "telephone_number": "216-659-6986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "302 W Main St",
            "address_purpose": "LOCATION",
            "city": "Fairborn",
            "state": "OH",
            "postal_code": "453245037",
            "country_code": "US",
            "telephone_number": "937-281-4673",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6570 Sosna Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "OH",
            "postal_code": "450142222",
            "country_code": "US",
            "telephone_number": "513-942-4673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VEGAS",
        "first_name": "LIBERTI",
        "middle_name": "E",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-12",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.2107143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Graysen Ray Charles Thompson
• Shannon Janelle Thompson, M.A.
• Tara Elizabeth Thompson, M.A., CCC-SLP
• Shenay Thurmond
• Aisha Touray
• Alejandra Vilches
• Jane Von Dohre, RN
• Cheyenne Waddell
• Karen Walker
• Angelina Jen Wallace

• Social Worker in West Carrollton, OH
• Providers in West Carrollton, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.