Active NPI
Vang Moua
- Professional Counselor
- Sparta, WI
National Provider Identifier
1114782117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Practice address
- 402 S Black River St
Sparta, WI 54656-2043 - Phone
- (608) 501-1189
- NPI assigned
- Feb 19, 2024
- Last updated
- Feb 19, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NU | Primary |
Addresses
Primary practice location
402 S Black River St
Sparta, WI 54656-2043
Mailing address
300 Liberty St Apt 2104
La Crosse, WI 54603-3206
Other practice location 1
522 Gateway Ave Ste F
Mauston, WI 53948-1450
Phone (608) 285-2133
Other practice location 2
435 Julie St Ste 2
Tomah, WI 54660-2924
Phone (608) 377-3864
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heart Line Counseling and Consulting | Past | Accepting new patients | |
| Amayla Empowerment Association, LLC | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Tomah, WI
- NPI 1659065530
-
- Clinical Social Worker
- Mauston, WI
- NPI 1023728284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1708300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708300800000",
"number": "1114782117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LIBERTY ST APT 2104",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546033206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 S BLACK RIVER ST",
"city": "SPARTA",
"state": "WI",
"postal_code": "546562043",
"telephone_number": "608-501-1189"
}
],
"practiceLocations": [
{
"address_1": "522 Gateway Ave Ste F",
"address_purpose": "LOCATION",
"city": "Mauston",
"state": "WI",
"postal_code": "539481450",
"country_code": "US",
"telephone_number": "608-285-2133",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "435 Julie St Ste 2",
"address_purpose": "LOCATION",
"city": "Tomah",
"state": "WI",
"postal_code": "546602924",
"country_code": "US",
"telephone_number": "608-377-3864",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOUA",
"first_name": "VANG",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-02-19",
"last_updated": "2024-02-19",
"certification_date": "2024-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparta, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.