Magdalene Kidd Vasconez

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007219 Issued in GA

Practice address

58646 McNulty Way
Saint Helens, OR 97051-6210

Phone

(912) 755-0906

NPI assigned

Nov 21, 2020

Sex

Female

Sole proprietor

Yes

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.

• Columbia Community Mental Health

  • Mental Health Counselor
  • Saint Helens, OR
  • NPI 1922066463

  OR

  Medicare reassignment Care Compare group
• Personal Recovery Network LLC

  • Psychiatry Physician
  • Stockbridge, GA
  • NPI 1881990869

  GA

  Medicare reassignment NPD
• Columbia Community Mental Health

  • Addiction (Substance Use Disorder) Counselor
  • Saint Helens, OR
  • NPI 1861617359
  NPD

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Community Mental Health 9 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in GA, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.magdalenevasconez@143219.advancedmd-direct.com

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 25, 2025.

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1265035158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58646 MCNULTY WAY",
            "city": "SAINT HELENS",
            "state": "OR",
            "postal_code": "970516210",
            "telephone_number": "912-755-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASCONEZ",
        "first_name": "MAGDALENE",
        "middle_name": "KIDD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-21",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007219",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L15511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dezaray Charrise Vandehey, QMHA
• Natallie Joy Vandyke, BA
• Samantha Lee Vanlaer, QMHA
• Linda A Vanlear, QMHP
• Jonathan Ray Vanzandt
• Bradley Charles Viles, CRM/ CADC1-R/ QMHA-R
• Scott Wachter, M.A., QMHP
• Amanda Wagner
• Ashly Ann Wagner, CADC-R
• Shannon Dee Wagner

• All providers in Saint Helens, OR
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.