Shaun Michael Vallery

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

435 NE Evans St Ste a
McMinnville, OR 97128-4635

Phone

(541) 201-3973

NPI assigned

May 18, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

Mental Health Counselor

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Portland, OR
  • NPI 1326056433

  OR

  Medicare reassignment NPD
• Lutheran Community Services Northwest

  • Community/Behavioral Health Agency
  • McMinnville, OR
  • NPI 1255542106
  NPD
• Lutheran Community Services Northwest

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Klamath Falls, OR
  • NPI 1720105489

  Mental Health

  NPD

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

{
    "created_epoch": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717891200000",
    "number": "1164096715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 NE EVANS ST STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284635",
            "telephone_number": "503-397-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 NE EVANS ST STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971284635",
            "telephone_number": "541-201-3973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "58646 McNulty Way",
            "address_purpose": "LOCATION",
            "city": "Saint Helens",
            "state": "OR",
            "postal_code": "970516210",
            "country_code": "US",
            "telephone_number": "503-397-5211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALLERY",
        "first_name": "SHAUN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-18",
        "last_updated": "2024-06-09",
        "certification_date": "2024-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan Urton
• Vernon Neal Utz Jr., PHARMACIST
• V2 Family & Cosmetic Dentistry
• Gloria Valdivia
• McKenzie Valenta, PSYD
• Joanna Colleen Valles
• Valley Women'S Health, PC
• Cassandra Louise Van Domelen, OTRL
• Timothy Van Ert, M.D.
• Amy Rae Van Heel, OD

• Mental Health Counselor in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Mental Health Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.