Individual provider Active NPI

Vanessa Marie Andersen, LISW

  • Clinical Social Worker
  • Grimes, IA
National Provider Identifier
1861839631
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
008207 Issued in IA
Practice address
1220 NE Station Xing Ste 114
Grimes, IA 50111-8013
Phone
(515) 380-6516
NPI assigned
Jun 3, 2013
Last updated
Oct 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 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 008207 IA Primary

Addresses

Primary practice location

1220 NE Station Xing Ste 114
Grimes, IA 50111-8013

Mailing address

1220 NE Station Xing Ste 114
Grimes, IA 50111-8013
Phone (153) 806-5165

Other practice location 1

306 N 3rd Ave E
Newton, IA 50208-3249
Phone (641) 792-4012

Other names 1

  • Ms. Vanessa Marie Shileny Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20221004003641 IA Practitioner - Clinical Social Worker 2264818806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capstone Behavioral Healthcare IncGroup PAC ID 0648169573, 13 clinicians

Practice addresses (Care Compare)

1123 1St Ave E
Suite 200
Newton, IA 50208-3981
Phone (641) 792-4012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008207IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Behavioral Healthcare, Inc CurrentSince Aug 31, 2022 Accepting new patients
Pink Couch Wellness CurrentSince May 14, 2023 Accepting new patients
Poweshiek County Mental Health Center Past Accepting new patients

Locations

1220 NE Station Xing
Ste 114
Grimes, IA 50111
Phone (515) 380-6516

200 4th Ave W
Grinnell, IA 50112
Phone (641) 236-6137

1123 1st Ave E
Ste 200
Newton, IA 50208
Phone (641) 792-4012

306 N 3rd Ave E
Newton, IA 50208
Phone (641) 792-4012

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1861839631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 NE STATION XING STE 114",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501118013",
            "telephone_number": "153-806-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 NE STATION XING STE 114",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501118013",
            "telephone_number": "515-380-6516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "306 N 3rd Ave E",
            "address_purpose": "LOCATION",
            "city": "Newton",
            "state": "IA",
            "postal_code": "502083249",
            "country_code": "US",
            "telephone_number": "641-792-4012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "VANESSA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "008207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "SHILENY",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "LMSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grimes, IA

Sources for this page

Verify at the official NPI Registry.