Individual provider Active NPI

Emily Regina Mleczko

  • Addiction (Substance Use Disorder) Registered Nurse
  • Brattleboro, VT
National Provider Identifier
1710639166
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
026.0145429 Issued in VT
Practice address
16 Town Crier Dr
Brattleboro, VT 05301-8669
Phone
(802) 258-4623
Fax
(802) 258-4629
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 026.0145429 VT Primary

Addresses

Primary practice location

16 Town Crier Dr
Brattleboro, VT 05301-8669

Mailing address

16 Town Crier Dr
Brattleboro, VT 05301-8669
Phone (802) 258-4623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
026.0145429VTMDAddiction (Substance Use Disorder) Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1710639166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 TOWN CRIER DR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053018669",
            "telephone_number": "802-258-4623",
            "fax_number": "802-258-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 TOWN CRIER DR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053018669",
            "telephone_number": "802-258-4623",
            "fax_number": "802-258-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MLECZKO",
        "first_name": "EMILY",
        "middle_name": "REGINA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "VT",
            "license": "026.0145429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.