Dominic Vachon, PHD.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20040854 Issued in IN

Practice address

837 Cedar St
Ste 100
South Bend, IN 46617-2069

Phone

(574) 237-7338

Fax

(574) 237-7881

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1780766261
  NPD (past)
• Saint Joseph Regional Medical Center-South Bend Campus, Inc.

  • General Acute Care Hospital
  • Mishawaka, IN
  • NPI 1841245594
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336224781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "837 CEDAR ST",
            "address_2": "STE 100",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172069",
            "telephone_number": "574-237-7338",
            "fax_number": "574-237-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 CEDAR ST",
            "address_2": "STE 100",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466172069",
            "telephone_number": "574-237-7338",
            "fax_number": "574-237-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHON",
        "first_name": "DOMINIC",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20040854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urology Associates of South Bend, PC
• Urology Associates of South Bend, PC
• Uthman Cavallo, MD, LLC
• V. Thomas Mawhinney, PH.D., Inc.
• Mauricio Vaca Pierola
• Mary Jane Vachon, LCSW
• Venu Vadlamudi, M.D.
• Cristina Valdez-Jones, MSW
• Karla Valenzuela Aguilera
• Jose Antonio Valle

• Clinical Psychologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.