Madissen Anne Vacha, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101008711 Issued in MI

Practice address

2450 44TH St SE Ste 201
Kentwood, MI 49512-9081

Phone

(616) 528-0870

Fax

(616) 591-5684

NPI assigned

Jul 18, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Duncan Lake Speech Therapy, LLC

  • Speech-Language Pathologist
  • Kentwood, MI
  • NPI 1376195925
  Medicare reassignment NPD

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

{
    "created_epoch": "1721260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1336987726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 44TH ST SE STE 201",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129081",
            "telephone_number": "616-528-0870",
            "fax_number": "616-591-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 44TH ST SE STE 201",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495129081",
            "telephone_number": "616-528-0870",
            "fax_number": "616-591-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHA",
        "first_name": "MADISSEN",
        "middle_name": "ANNE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101008711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• United Hearts Home Care, LLC
• United Pharmaceutical Services Inc.
• Unity Senior Care LLC
• Courtney Albin Upchurch, MAC, LPC, CAADC
• Jack W. Urben, PHARM.D.
• Peter Jeffrey Vance, M.D.
• Jaqueline Regina Vandenberg, BEHAVIOR TECHNICIAN
• Julia Lynn Vandenbosch, LMSW
• Marie Vander Linde, MD
• Megan Vanderhoof, OTRL

• Speech-Language Pathologist in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.