Juliet Ann Russom Walden, BS, AM, LSCW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.014305 Issued in IL

Practice address

13136 Western Ave
Blue Island, IL 60406-2423

Phone

(708) 974-5800

NPI assigned

May 17, 2011

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: juliet.walden.1@28621.direct.athenahealth.com

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.

• KP Counseling LTD

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1770630766
  NPD
• Optum Behavioral Care Therapy Services of Illinois PC

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1235949553
  NPD
• Optum Behavioral Care Therapy Services of Illinois PC

  • Clinical Social Worker
  • Rockford, IL
  • NPI 1780579797
  NPD
• Metropolitan Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1841460391
  NPD (past)

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

{
    "created_epoch": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433289600000",
    "number": "1154614634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 W 22ND PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606084205",
            "telephone_number": "773-247-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13136 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062423",
            "telephone_number": "708-974-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDEN",
        "first_name": "JULIET",
        "middle_name": "ANN RUSSOM",
        "name_prefix": "Ms.",
        "credential": "BS, AM, LSCW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-17",
        "last_updated": "2015-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.014305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salvatore Ventura, MD
• Vision Salon Eye Care Associates
• Louis Volpi III, C.R.S.S.
• VVN Dental PC
• Susan N Wagner, APRNCNS
• Walgreen Co
• Toyar Walker
• Earnest Wallace
• Carol Palmer Wardlaw, RN,APN
• Julia Wegmann, MSW, LSW

• Clinical Social Worker in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.