NPIMap

Organization Active NPI

Vicki L. Eaton, PC

  • Clinical Social Worker
  • Mesa, AZ
National Provider Identifier
1699954891
Registry record updated Apr 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-005721 Issued in IL
Legal business name
VICKI L. EATON, PC
Doing business as
Vicki L Eaton PC
Practice address
825 W Jerome Cir
Mesa, AZ 85210-5939
Phone
(480) 603-5360
NPI assigned
Oct 24, 2007
Last updated
Apr 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2020

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

Authorized official

Name
Ms. Vicki Lee Eaton, LCSWNPI 1629148697
Title
President
Phone
(480) 603-5360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 149-005721 IL Primary

Addresses

Primary practice location

825 W Jerome Cir
Mesa, AZ 85210-5939

Mailing address

1501 Coventry Rd
Schaumburg, IL 60195-3229
Phone (847) 781-1407

Other identifiers 1

IdentifierTypeStateIssuer
01626654OtherILBLUE CROSS BLUE SHIELD

Other names 1

  • Vicki L Eaton PC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586304000000",
    "number": "1699954891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 COVENTRY RD",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601953229",
            "telephone_number": "847-781-1407",
            "fax_number": "847-781-1407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W JEROME CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105939",
            "telephone_number": "480-603-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKI L. EATON, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2020-04-08",
        "certification_date": "2020-04-08",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-603-5360",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-005721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01626654",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vicki L Eaton PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; 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.