Individual provider Active NPI

Nadine Valerie Vaz, LMSW

  • Clinical Social Worker
  • Okemos, MI
National Provider Identifier
1831571710
Registry record updated Sep 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081893 Issued in MI
Practice address
3493 Woods Edge
Ste 103
Okemos, MI 48864-5911
Phone
(517) 886-3707
Fax
(517) 349-1973
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 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 6801081893 MI Primary

Addresses

Primary practice location

3493 Woods Edge
Ste 103
Okemos, MI 48864-5911

Mailing address

2820 Baker Rd Ste 100
Dexter, MI 48130-1196
Phone (734) 580-2920

Other names 1

  • Nadine Valerie Johnson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20150806011004 MI Practitioner - Clinical Social Worker 1254645088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peaceful Mind Counseling Services LLCGroup PAC ID 9739437138, 15 clinicians

Practice addresses (Care Compare)

2820 Baker Rd
Suite 100
Dexter, MI 48130-1196
Phone (734) 580-2920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801081893MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peaceful Mind Counseling Services LLC CurrentSince Aug 1, 2022 Accepting new patients
Sasco Dexter LLC PastSince Aug 1, 2022 Accepting new patients

Locations

2820 Baker Rd
Ste 100
Dexter, MI 48130
Phone (734) 580-2920

Organizations & group practices 2

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": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663113600000",
    "number": "1831571710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2820 BAKER RD STE 100",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301196",
            "telephone_number": "734-580-2920",
            "fax_number": "734-580-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3493 WOODS EDGE",
            "address_2": "STE 103",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488645911",
            "telephone_number": "517-886-3707",
            "fax_number": "517-349-1973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZ",
        "first_name": "NADINE",
        "middle_name": "VALERIE",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2022-09-14",
        "certification_date": "2022-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NADINE",
            "last_name": "JOHNSON",
            "middle_name": "VALERIE",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.