Mandy Wallenfelsz

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.179510 Issued in OH

Practice address

517 3Rd Ave
Chesapeake, OH 45619-1036

Phone

(740) 451-1455

NPI assigned

Jan 30, 2019

Last updated

Feb 19, 2024By the provider in NPPES

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

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/landofgoshentreatmentcenter/r4/

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.

• Land of Goshen Treatment Center, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ironton, OH
  • NPI 1003571795
  NPD (past)
• Land of Goshen Treatment Center, Inc

  • Substance Abuse Rehabilitation Facility
  • Ironton, OH
  • NPI 1568822633
  NPD (past)

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1184188427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 TOWNSHIP ROAD 349",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456388617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 3RD AVE",
            "city": "CHESAPEAKE",
            "state": "OH",
            "postal_code": "456191036",
            "telephone_number": "740-451-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Brubaker Dr",
            "address_purpose": "LOCATION",
            "city": "South Point",
            "state": "OH",
            "postal_code": "456809432",
            "country_code": "US",
            "telephone_number": "606-939-8089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLENFELSZ",
        "first_name": "MANDY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.179510",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justin Vancooney
• Amy Vansant
• Ashley Jade Varney
• James Varney
• Casey Wallenfelsz
• Brandon Waller
• Louis Warren
• Phyllis Amanda Watkins
• Estell Watts
• Tammie L. Wayne

• Addiction (Substance Use Disorder) Counselor in Chesapeake, OH
• Providers in Chesapeake, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• 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.

Verify at the official NPI Registry.