Patricia Marie Wilkins-Vacca, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069452 Issued in NY

Practice address

15 Davis Ave
Poughkeepsie, NY 12603-7212

Phone

(845) 527-9456

Fax

(845) 473-0628

NPI assigned

Dec 16, 2005

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 1, 2018 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1770569360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 E BANK RD",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031432",
            "telephone_number": "845-527-9456",
            "fax_number": "845-473-0628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DAVIS AVE",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126037212",
            "telephone_number": "845-527-9456",
            "fax_number": "845-473-0628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS-VACCA",
        "first_name": "PATRICIA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-16",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER #",
            "identifier": "P2586785",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02469689",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PROVIDER #",
            "identifier": "781305",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Wikane, M.S. CCC-SLP
• Joshua Wilburn, LMHC
• Carla Y Wiles, M.D.
• Janelle Wilkerson, PA-C
• Alandria Wilkins Green
• Emma Wilkinson, MD
• Spencer Wilkinson
• Yasmin Reid Wilkinson, ATC
• William Bollengier MD, PC
• William E. Bollengier, M.D., P.C.

• Clinical Social Worker in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.