Individual provider Active NPI

Franchesca Carley Vasquez, APSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1730821364
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
132625 Issued in WI
Practice address
1061 W Mason St
Green Bay, WI 54303-1858
Phone
(920) 437-8256
NPI assigned
Apr 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 132625 WI Primary

Addresses

Primary practice location

1061 W Mason St
Green Bay, WI 54303-1858

Mailing address

1061 W Mason St
Green Bay, WI 54303-1858
Phone (920) 437-8256

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20231201000583 WI Practitioner - Clinical Social Worker 8426406406 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
132625WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
CCP Clinic, LLC Clinical CurrentSince Sep 26, 2023 Accepting new patients

Locations

424 E Longview Dr
Appleton, WI 54911
Phone (920) 234-9240

3301 Packerland Dr
Ste B
De Pere, WI 54115
Phone (920) 234-9240

Organizations & group practices 1

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": "1649808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1730821364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-437-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 W MASON ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543031858",
            "telephone_number": "920-437-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLEY VASQUEZ",
        "first_name": "FRANCHESCA",
        "credential": "APSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-13",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "132625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.