Individual provider Active NPI

Virginia S Vassen, LCSW

  • Clinical Social Worker
  • Sheridan, WY
National Provider Identifier
1295828366
Registry record updated Apr 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
567 Issued in WY
Practice address
1221 W 5TH Sreet
Sheridan, WY 82801-2701
Phone
(307) 674-4405
Fax
(307) 673-5167
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2745 ND
Clinical Social Worker 1041C0700X 567 WY Primary

Addresses

Primary practice location

1221 W 5TH Sreet
Sheridan, WY 82801-2701

Mailing address

1221 W 5TH St
Sheridan, WY 82801-2701
Phone (307) 674-4405

Other identifiers 2

IdentifierTypeStateIssuer
21751OtherWYMEDICARE PTAN
54516MedicaidND

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2745NDMDClinical Social Worker
567WYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207094400000",
    "number": "1295828366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 W 5TH ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012701",
            "telephone_number": "307-674-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 W 5TH SREET",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828012701",
            "telephone_number": "307-674-4405",
            "fax_number": "307-673-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASSEN",
        "first_name": "VIRGINIA",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "2745",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "21751",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "54516",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.