NPIMap

Individual provider Active NPI

Melissa Marie Vargas, LMSW, CCS, CAADC

  • Clinical Social Worker
  • Adrian, MI
National Provider Identifier
1184138505
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801096528 Issued in MI
Practice address
770 Riverside Ave Ste 11
Adrian, MI 49221-1465
Phone
(517) 264-2244
Fax
(517) 263-3325
NPI assigned
Nov 21, 2017
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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 C-03022 MI
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 6801096528 MI Primary

Addresses

Primary practice location

770 Riverside Ave Ste 11
Adrian, MI 49221-1465

Mailing address

770 Riverside Ave Ste 11
Adrian, MI 49221-1465
Phone (517) 264-2244

Other names 1

  • Ms. Melissa Marie Young Former name

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
C-03022MIMDAddiction (Substance Use Disorder) Counselor
6801096528MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
McCullough Vargas and Associates Inc Past Accepting new patients
Lenawee Community Mental Health Authority Past Accepting new patients
Lenawee Community Mental Health Authority PastSince Oct 1, 2001 Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1511222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1184138505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 RIVERSIDE AVE STE 11",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211465",
            "telephone_number": "517-264-2244",
            "fax_number": "517-263-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 RIVERSIDE AVE STE 11",
            "city": "ADRIAN",
            "state": "MI",
            "postal_code": "492211465",
            "telephone_number": "517-264-2244",
            "fax_number": "517-263-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "MELISSA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMSW, CCS, CAADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-21",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": "C-03022",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801096528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "YOUNG",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Adrian, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.

Verify at the official NPI Registry.