Audra Van Tassell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4935 Issued in CT

Practice address

64 Thompson St # a-103104
East Haven, CT 06513-5707

Phone

(203) 691-1685

NPI assigned

Jun 28, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holistic Health and Healing Center LLCGroup PAC ID 1557774486, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Holistic Health & Healing Center LLC

  • Clinical Social Worker
  • East Haven, CT
  • NPI 1659728012
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1285204602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 THOMPSON ST # A-103104",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065135707",
            "telephone_number": "203-691-1685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 THOMPSON ST # A-103104",
            "city": "EAST HAVEN",
            "state": "CT",
            "postal_code": "065135707",
            "telephone_number": "203-691-1685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSELL",
        "first_name": "AUDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-28",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "4935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Urbano
• Talyah Uslianer
• Utopia Assisted Living Services
• Utopia Home Care Inc
• Sarah Uzzaman
• Vandlik, Furino, and Associates, LLC
• Michael John Vandlik, DMD
• Priya Varghese
• Daniel John Varley
• Michael Joseph Vessicchio, PHARMD.

• Professional Counselor in East Haven, CT
• Providers in East Haven, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.