Vidya Vijayan, LMSW, PHD

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2024032666 Issued in MO

Practice address

237 Creekside Office Dr
Wentzville, MO 63385

Phone

(636) 202-1412

NPI assigned

Oct 24, 2024

Last updated

Nov 5, 2024By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• A W Stevenson LLC

  dba Ellie Mental Health

  • Professional Counselor
  • Saint Charles, MO
  • NPI 1396469060
  NPD

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1730900440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "237 CREEKSIDE OFFICE DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-202-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "237 CREEKSIDE OFFICE DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "63385",
            "telephone_number": "636-202-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIJAYAN",
        "first_name": "VIDYA",
        "name_prefix": "Dr.",
        "credential": "LMSW, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2024032666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shailee Saran Varanasi, RDN, LD
• Gretchen A Vaughn
• David Vega Jr., DC
• Jordan Verbanaz
• Kathleen Veys, LPC, ATR, MA
• Village Center Care of Wentzville LLC
• Christopher Pearson Voll, D.C.
• Jeanne Marie Voss
• Lauren M Wagner, DMD
• Meredith E Wagnon

• Social Worker in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.