Taylor Kristine Vacca, MA, BS

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

10729 Town Square Dr NE Ste 120
Blaine, MN 55449-7923

Phone

(763) 343-9010

Fax

(763) 343-9011

NPI assigned

Mar 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science, Master of Arts

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.

• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1164007282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10729 TOWN SQUARE DR NE STE 120",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497923",
            "telephone_number": "763-343-9010",
            "fax_number": "763-343-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10729 TOWN SQUARE DR NE STE 120",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554497923",
            "telephone_number": "763-343-9010",
            "fax_number": "763-343-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCA",
        "first_name": "TAYLOR",
        "middle_name": "KRISTINE",
        "name_prefix": "Ms.",
        "credential": "MA, BS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• U.S. Healthworks Medical Group of Minnesota, PC
• Universer Healthcare Services LLC
• University Ave Dental, PLLC
• Jennifer Lynn Urbach, MA, LPCC
• V Mental Wellness, PLLC
• Bao Vang
• Christelle Vang, D.C.
• Nhia Tong Vang
• Tong Vang, DIGITAL HEALTH COACH
• Daniel J Vanhouse, PT

• Professional Counselor in Blaine, MN
• Providers in Blaine, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.