Christy Vachavake

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

11912-123 Issued in WI

Practice address

2761 Allied St FL 1
Green Bay, WI 54304-5501

Phone

(920) 215-0243

NPI assigned

Nov 6, 2024

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  WI

  Medicare reassignment NPD

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1508689589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2761 ALLIED ST FL 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2761 ALLIED ST FL 1",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045501",
            "telephone_number": "920-215-0243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHAVAKE",
        "first_name": "CHRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-06",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "11912-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• US Department of Veteran Affairs
• Lauren Isabel Useem, D.O, MPH
• John W Utrie, DO
• Paul C Utrie, MD
• Molly Marie Uvaas, PA-C
• Vagabond Shoes, Inc.
• Dhwani A Vaishnav, MD
• Alexandra Deniz Valdez
• Dylan A. Valentine, DNP
• Lynette M. Valentine, R.N.

• Clinical Social Worker in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.