Individual provider Active NPI

Jose J. Vasquez, LCSW

  • Mental Health Counselor
  • Wappingers Falls, NY
National Provider Identifier
1184796757
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R037723-1 Issued in NY
Practice address
1285 Route 9
Suite 7B
Wappingers Falls, NY 12590
Phone
(845) 632-2939
Fax
(845) 632-2940
NPI assigned
Nov 15, 2006
Last updated
Feb 15, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R037723-1 NY Primary

Addresses

Primary practice location

1285 Route 9
Suite 7B
Wappingers Falls, NY 12590

Mailing address

1285 Route 9
Suite 7B
Wappingers Falls, NY 12590
Phone (845) 632-2939

Other identifiers 1

IdentifierTypeStateIssuer
1184796757MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000216 NY Practitioner - Clinical Social Worker 7214925049 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1285 Route 9
Suite 7B
Wappingers Falls, NY 12590-4993
Phone (845) 202-0509

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R037723-1NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
County of Westchester PastSince Jun 16, 2024 Accepting new patients

Organizations & group practices 3

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1184796757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 ROUTE 9",
            "address_2": "SUITE 7B",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "12590",
            "telephone_number": "845-632-2939",
            "fax_number": "845-632-2940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 ROUTE 9",
            "address_2": "SUITE 7B",
            "city": "WAPPINGERS FALLS",
            "state": "NY",
            "postal_code": "12590",
            "telephone_number": "845-632-2939",
            "fax_number": "845-632-2940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JOSE",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R037723-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184796757",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wappingers Falls, NY

Sources for this page

Verify at the official NPI Registry.