Bradley M Vivoda, CSAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

12488-132 Issued in WI

Practice address

3301 N Ballard Rd
Appleton, WI 54911-8928

Phone

(920) 733-4443

NPI assigned

Dec 19, 2022

Sex

Male

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

State licenses

Practice roles

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.

• Milwaukee Health Services

  • Substance Abuse Rehabilitation Facility
  • Appleton, WI
  • NPI 1578883567
  NPD (past)

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

{
    "created_epoch": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1427760735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118928",
            "telephone_number": "920-733-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 N BALLARD RD",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549118928",
            "telephone_number": "920-733-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVODA",
        "first_name": "BRADLEY",
        "middle_name": "M",
        "credential": "CSAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "12488-132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Virago Wellness Initiative, LLC
• Virtual Sleep Solutions LLC
• Maresa Visel, DPT
• Vision Mart, Inc (Vision Mart)
• Vitality Transport Services LLC
• Maria Jacoba Vlach, RN
• Amy Sue Vlosak, COTA
• Christy Vogel
• Kathy A Vogel, MD
• Lee M Vogel, MD

• Addiction (Substance Use Disorder) Counselor in Appleton, WI
• Providers in Appleton, WI by specialty
• Addiction (Substance Use Disorder) Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.