Stephanie Vandervall, MS,CACAD

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

AC1683 Issued in MD

Practice address

1501 W Saratoga St
Baltimore, MD 21223-1749

Phone

(410) 383-3129

NPI assigned

Dec 10, 2014

Last updated

Dec 10, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Master of Science

State licenses

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

{
    "created_epoch": "1418169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1386042125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W SARATOGA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231749",
            "telephone_number": "410-383-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W SARATOGA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212231749",
            "telephone_number": "410-383-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVALL",
        "first_name": "STEPHANIE",
        "credential": "MS,CACAD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-10",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "AC1683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Berendena Irene Monsma Vander Tuig, MD
• Gillian Vander Tuig
• Samuel Vanderhoek, M.D.
• Peter Vandermeer, MD
• Amy Lynn Vanderstoep, MD
• Theresa Vandervall
• Holly Vanderwalde
• Kate Vanderzant, M.S.
• Nyajei Vandi, DO
• Roland Dang Vando

• Addiction (Substance Use Disorder) Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.