Jacqueline Brandy Vedder, LMFT, LCAC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

35002029A Issued in IN

Practice address

2712 S Calhoun St
Fort Wayne, IN 46807-1402

Phone

(260) 744-4326

NPI assigned

Aug 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jacqueline Brandy McCoy Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Marriage and Family Therapist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renewal Therapy Services LLCGroup PAC ID 0749712156, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Renewal Therapy Services LLC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1699503136

  Addiction (Substance Use Disorder)

  Medicare reassignment Care Compare group NPD
• Family & Childrens Service of Fort Wayne Inc

  • Community/Behavioral Health Agency
  • Fort Wayne, IN
  • NPI 1699820720
  NPD

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1881148666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071402",
            "telephone_number": "260-744-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468071402",
            "telephone_number": "260-744-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDDER",
        "first_name": "JACQUELINE",
        "middle_name": "BRANDY",
        "credential": "LMFT, LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-09",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001621A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35002029A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MCCOY",
            "middle_name": "BRANDY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veronica A Vaughn, MSW, LCSW
• Kevin Alton Vaught, MD
• Mohammad Ali Vaziri, M.D.
• Brenda Vazquez, MD
• Emilio J Vazquez, MD
• Daniel Newton Veerkamp, DMD
• Gregory W Veerkamp, MD
• Mary Pat Veerkamp, MD
• Patrick M. Veerkamp, M.D.
• Giridhar Rao Veerula

• Marriage & Family Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Marriage & Family Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.