Avandra Mental Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

AVANDRA MENTAL WELLNESS LLC

Practice address

3010 Union St
Madison, WI 53714-1850

Phone

(269) 762-2421

NPI assigned

Aug 14, 2023

Last updated

Mar 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bianca WhitneyNPI 1285293530

Title

Owner

Phone

(262) 769-2421

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bianca Whitney, MSW

  • Clinical Social Worker
  • Madison, WI
  • NPI 1285293530
  Medicare reassignment Authorized official
• Tori Rae Bartkowiak, MSW, LCSW

  • Clinical Social Worker
  • Madison, WI
  • NPI 1245890623
  Medicare reassignment NPD
• Katrina Rose Moore, MSW, LCSW

  • Clinical Social Worker
  • Madison, WI
  • NPI 1912567215
  Medicare reassignment

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1336922558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 UNION ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537141850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 UNION ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537141850",
            "telephone_number": "269-762-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANDRA MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "BIANCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-769-2421"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autism Spectrum Therapies of Delaware, LLC (Wisconsin Early Autism Project)
• Brian Joseph Autry, PHARMD, MPH
• Avail Therapeutic Services LLC
• Dezarae Avalos
• Velma G Avalos
• Avenues to Community Inc
• Charlene M Avery
• Pamela Avery, MD
• Gregory D Avey, M.D.
• Aaron Axelbaum, MD

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.