Active NPI
Carol Marie Vidacak, LMSW
- Social Worker
- Troy, MO
National Provider Identifier
1346916285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 2021028324
- Practice address
- 91 Troy SQ Ste 101
Troy, MO 63379-3228 - Phone
- (844) 853-8937
- NPI assigned
- Aug 20, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 2021028324 | MO | Primary |
Addresses
Primary practice location
91 Troy SQ Ste 101
Troy, MO 63379-3228
Mailing address
1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131
Other names 1
- Carol Belman
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021028324 | MO | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1346916285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 COMMUNITY",
"city": "CLINTON",
"state": "MO",
"postal_code": "647358804",
"telephone_number": "660-885-8131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 TROY SQ STE 101",
"city": "TROY",
"state": "MO",
"postal_code": "633793228",
"telephone_number": "844-853-8937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDACAK",
"first_name": "CAROL",
"middle_name": "MARIE",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-20",
"last_updated": "2021-08-20",
"certification_date": "2021-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MO",
"license": "2021028324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CAROL",
"last_name": "BELMAN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Troy, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.