Jeanette P Vasquez, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3444653501 Issued in UT

Practice address

2180 E 4500 S
Unit #105
Holladay, UT 84117-4434

Phone

(801) 680-4728

Fax

(801) 748-2554

NPI assigned

Nov 30, 2007

Last updated

Jul 27, 2012By 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

Other names 1

• Jeanette P Kuhre Former name

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ascendant Behavioral Health LLCGroup PAC ID 1850673187, 62 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lifestancehealth.jeanettevasquez@154909.advancedmd-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ascendant Behavioral Health LLC

  dba Ascendant Behavioral Health DBA LifeStance

  • Clinical Social Worker
  • Murray, UT
  • NPI 1689128605
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343347200000",
    "number": "1477735504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5451 S 1410 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177359",
            "telephone_number": "801-680-4728",
            "fax_number": "801-748-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 E 4500 S",
            "address_2": "UNIT #105",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841174434",
            "telephone_number": "801-680-4728",
            "fax_number": "801-748-2554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "JEANETTE",
        "middle_name": "P",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-30",
        "last_updated": "2012-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "3444653501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANETTE",
            "last_name": "KUHRE",
            "middle_name": "P",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• University Health Care Quick Clinic
• Uplift for Her, LLC
• Upri East, LLC
• Utah Body & Soul
• Emily Kristen Van Os, PMHNP-BC, FNP-C
• Veri Recovery LLC
• Veridicus Consulting
• Walgreen Co (Walgreens #17008)
• Walgreen Co (Rite Aid #17008)
• Bradley Stephen Walker, DMD

• Clinical Social Worker in Holladay, UT
• Providers in Holladay, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.