Kelsey Janine Vasicek, BS, LCDC III, GAMBP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

162490 Issued in OH

Practice address

555 Independence Dr
Medina, OH 44256-2460

Phone

(330) 635-0969

NPI assigned

Jan 15, 2019

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1477027290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 NORTHLAND DR STE 200A",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442563440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 INDEPENDENCE DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442562460",
            "telephone_number": "330-635-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASICEK",
        "first_name": "KELSEY",
        "middle_name": "JANINE",
        "credential": "BS, LCDC III, GAMBP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-15",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "162490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cariley Van Drei
• Julia Vana
• Lorie Marie Vandenbusche, RN., CNP
• Terese Angela Varga, LPCC, CRC
• Natalie Varrone, LPCC-S
• Rose Vasilakis
• Joselyn Vasquez, MSSA, LISW
• Holly Deanne Vavlas, LPC
• Roy Vellanki, MD
• Pushpalatha Tirumale Venkataraman, PHYSICIAN ASSISTANT

• Addiction (Substance Use Disorder) Counselor in Medina, OH
• Providers in Medina, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.