Individual provider Active NPI

Tracy Lee Vanden Heuvel, LCSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1417197583
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7459-123 Issued in WI
Practice address
6314 Odana Rd
Madison, WI 53719-1129
Phone
(608) 277-0610
NPI assigned
Mar 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7459-123 WI Primary

Addresses

Primary practice location

6314 Odana Rd
Madison, WI 53719-1129

Mailing address

414 S Iowa St
Dodgeville, WI 53533-1720
Phone (608) 935-9235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141119002396 WI Practitioner - Clinical Social Worker 8325260706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Platteville Family Resource Center IncGroup PAC ID 0042295016, 7 clinicians

Practice addresses (Care Compare)

1075 N Elm St
Platteville, WI 53818-1205
Phone (608) 348-4060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Platteville Family Resource Center Inc CurrentSince Jun 18, 2014 Accepting new patients
Dean Health Systems, Inc, Past Accepting new patients
Agrace Hospicecare, Incorporated Past Accepting new patients
Platteville Family Resource Center Past Accepting new patients

Locations

219 W Maple St
Lancaster, WI 53813
Phone (608) 723-4229

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235952000000",
    "number": "1417197583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 S IOWA ST",
            "city": "DODGEVILLE",
            "state": "WI",
            "postal_code": "535331720",
            "telephone_number": "608-935-9235",
            "fax_number": "608-935-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6314 ODANA RD",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537191129",
            "telephone_number": "608-277-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEN HEUVEL",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7459-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.