Individual provider Active NPI

Denise Jill Vandewalker, LPC

  • Professional Counselor
  • Salem, OR
National Provider Identifier
1063635951
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
C2458 Issued in OR
Practice address
401 Ratcliff Dr SE Ste 10
Salem, OR 97302-4980
Phone
(503) 979-4346
Fax
(503) 980-7885
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X C2458 OR Primary

Addresses

Primary practice location

401 Ratcliff Dr SE Ste 10
Salem, OR 97302-4980

Mailing address

PO Box 5861
Salem, OR 97304-0861
Phone (503) 979-4346

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C2458ORMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Steadfast Counseling LLC Professional CurrentSince Nov 5, 2023 Accepting new patients

Organizations & group practices 1

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": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1063635951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5861",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973040861",
            "telephone_number": "503-979-4346",
            "fax_number": "503-980-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RATCLIFF DR SE STE 10",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973024980",
            "telephone_number": "503-979-4346",
            "fax_number": "503-980-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEWALKER",
        "first_name": "DENISE",
        "middle_name": "JILL",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.