Individual provider Active NPI

Vanessa Victoria Rodriguez Vargas, PSYAD, LMHC

  • Psychoanalysis Psychologist
  • Boston, MA
National Provider Identifier
1508327495
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychoanalysis PsychologistTaxonomy code 103TP0814X
License
10000230 Issued in MA
Practice address
10 Derne St Ste 402
Boston, MA 02114-4203
Phone
(617) 903-0968
Fax
(857) 219-2227
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 10000230 MA
Counseling Psychologist 103TC1900X 10000230 MA
Psychoanalysis Psychologist 103TP0814X 10000230 MA Primary
Psychologist 103T00000X 10000230 MA

Addresses

Primary practice location

10 Derne St Ste 402
Boston, MA 02114-4203

Mailing address

10 Derne St Ste 402
Boston, MA 02114-4203
Phone (617) 903-0968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240112000340 MA Practitioner - Mental Health Counselor 6901257195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10000230MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
VVRV Analysis, LLC Mental Health CurrentSince May 11, 2025 Accepting new patients
Thrive Counseling LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

10 Derne St
Ste 402
Boston, MA 02114
Phone (617) 903-0968

112 Water St
Ste 203
Boston, MA 02109
Phone (617) 882-7447

872 Massachusetts Ave
Ste 2-2
Cambridge, MA 02139
Phone 6173804651 ext. 1992

Organizations & group practices 2

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1508327495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DERNE ST STE 402",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144203",
            "telephone_number": "617-903-0968",
            "fax_number": "857-219-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DERNE ST STE 402",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021144203",
            "telephone_number": "617-903-0968",
            "fax_number": "857-219-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ VARGAS",
        "first_name": "VANESSA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "PSYAD, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "10000230",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MA",
            "license": "10000230",
            "primary": false
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "MA",
            "license": "10000230",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "10000230",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.