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KELSEY JANINE VASICEK BS, LCDC III, GAMBP
NPI 1477027290
Counselor - Addiction (Substance Use Disorder) in Medina, OH

Active since January 15, 2019PECOS Enrolled
555 INDEPENDENCE DR, MEDINA, OH 44256(330) 635-0969 Get Directions Write a Review

NPPES record last updated: May 11, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: May 11, 2023, Jan 15, 2019 (2 updates tracked since 2019).

About Kelsey Janine Vasicek Bs, Lcdc Iii, Gambp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSEY JANINE VASICEK BS, LCDC III, GAMBP (NPI 1477027290) is an individual addiction (substance use disorder) provider in Medina, Ohio, licensed in Ohio (162490) and active in the NPI registry since January 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1477027290
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameKELSEY JANINE VASICEKCredential: BS, LCDC III, GAMBP
Location Address555 INDEPENDENCE DRMedina, OH 44256-2460
Mailing Address246 Northland Dr Ste 200aMedina, OH 44256-3440
Phone(330) 635-0969
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateJanuary 15, 2019
Last NPPES UpdateMay 11, 20232 updates tracked since enumeration
NPPES CertifiedMay 11, 2023
✔ NPI 1477027290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in OH · 162490
555 INDEPENDENCE DR, Medina, OH 44256
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelsey Janine Vasicek Bs, Lcdc Iii, Gambp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527530005
PECOS Enrollment IDI20260616001731
Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsey Vasicek's NPI number?

The NPI number for Kelsey Vasicek is 1477027290. It was assigned to this individual provider in the NPPES registry on January 15, 2019.

Where is Kelsey Vasicek located?

Kelsey Vasicek practices at 555 Independence Dr, Medina, OH 44256. The listed phone number is (330) 635-0969.

What is Kelsey Vasicek's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Kelsey Vasicek enrolled in Medicare?

Yes. Kelsey Vasicek is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelsey Vasicek was last updated on May 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.