Jennifer Vann, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3658-57 Issued in WI

Practice address

2428 N Grandview Blvd Ste 101
Waukesha, WI 53188-6906

Phone

(262) 259-4100

Fax

(262) 290-5756

NPI assigned

Jul 21, 2016

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

Enrolled in WI

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

Clinical Psychologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wellness West LLCGroup PAC ID 4789052820, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Wellness West LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waukesha, WI
  • NPI 1306569629
  Medicare reassignment Care Compare group NPD Authorized official
• Thousand Mile Journey LLC

  • Family Nurse Practitioner
  • Milwaukee, WI
  • NPI 1699159962
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1922451285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 N GRANDVIEW BLVD STE 101",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886906",
            "telephone_number": "262-259-4100",
            "fax_number": "262-290-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 N GRANDVIEW BLVD STE 101",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531886906",
            "telephone_number": "262-259-4100",
            "fax_number": "262-290-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANN",
        "first_name": "JENNIFER",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3658-57",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Helen Vanderwerff, RN
• Michelle Arlene Vanderwyst, RDH
• Erin Elizabeth Vanevenhoven
• Blia Vang
• Chelsie Vanlieshout, SAC-IT
• Jennifer Vanrossum, LPC
• Ronald Gerard Varchetto Jr., PA
• Vijay M Varghese
• Emma Vasquez
• Gabriela Vasquez

• Clinical Psychologist in Waukesha, WI
• Providers in Waukesha, WI by specialty
• Clinical Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.